Cardiac
Introduction
10 – 15% of all cardiomyopathies in young adults are related to previous treatment for cancer.
Cardiac injury is a significant cause of mortality and morbidity in cancer survivors (10X risk compared to general population)6
Cardiopulmonary disease is the 3rd most common cause of death for patients after treatment for a pediatric malignancy.
For long-term survivors of childhood cancer:
- First cause of death: Recurrence of the primary malignancy
- Second cause of death: Second malignancy6
- Third cause of death: Cardiac Injury
The risk of Injury to the heart depends on:
Patient factors:
- Genetic factors
- pharmacogenomics
- Down's syndrome ( trisomy 21)
- gender4
Tumor factors:
- Direct extension of the tumor to involve the heart
Treatment factors:
- Radiation Therapy4
- Chemotherapy
- Anthracyclines are most commonly associated with cardiac damage (daunorubicin and doxorubicin)4
Damage to the heart may present as:
- Cardiomyopathy (heart muscle damage - dilated and/or restrictive)
- Premature ischemic heart disease
- Pericarditis
- Valvular injury
