Design of a cardio-oncology unit: five years of efficient and timely multidisciplinary care

Abstract Background/Introduction Since the introduction of the European cardio-oncology guidelines from 2022 (1), the need to establish dedicated Cardio-Oncology Units has emerged as an essential requirement. These units facilitate a multidisciplinary approach to optimizing patient treatment while safely minimizing cardiovascular complications. Maintaining an efficient workflow is crucial to ensuring timely cardiological assessments, both before and during specific onco-hematological treatments, as well as for monitoring cardiotoxicity. In 2020, a high-resolution Cardio-Oncology Unit equipped with its own echocardiogram was established with the aim of meeting these objectives in the short and medium term (2-3). Purpose To evaluate the development of the Cardio-Oncology Unit at a reference hospital and assess its capacity to provide timely responses to the requests from hematology and medical oncology services. Methods A retrospective analysis was conducted on all patients attended in the Cardio-Oncology Unit from its inception in 2020 until 2025. We reviewed consultation requests (both initial and follow-up) and the underlying onco-hematological conditions. The number of Transthoracic echocardiograms (TTE) performed within the unit was recorded. Additionally, the response time over the past year was analyzed, defined as the "time elapsed from the request for an initial consultation (by the oncologist or hematologist) to the in-person cardiology assessment" in the Cardio-Oncology Unit. Results The evolution of consultations over these first five years is illustrated in Figure 1. In 2024, a total of 1220 consultations were conducted, including 515 initial visits and 705 follow-ups, with nearly 1000 echocardiograms performed during the consultations. The initial growth (from 2020 to 2021) can be attributed to the transition from previous cardiac function assessments using MUGA scans to TTE. Subsequently, in line with the objective of maintaining a sustainable balance to ensure continuous care, the number of annual patient evaluations has remained relatively stable. Breast cancer patients accounted for 29% of initial consultations and 63% of follow-ups, including long-term HER2-positive survivors. The response times were appropriate, with no waiting list: 8.4% of first consultations were conducted within 24 hours, and more than 67.4% within one week, as per oncologist/hematologists requests. Conclusions The design of the hospital’s Cardio-Oncology Unit has successfully provided sustained and efficient care for onco-hematological patients requiring cardiological assessments, including in-clinic TTE.