ESTRO Multidisciplinary Management of Breast Cancer 2017

Cardiovascular toxicity - chemotherapy

• Myocardial ischemia and infarction very rarely

• Cardiomyopathy (and pericarditis)

• Symptoms: non-specific; tachycardia, dyspnea, cardiomegaly,

peripheral and pulmonary edema

• Anthracyclines and high dose chemotherapy may produce fatal

cardiomyopathy

• Acute drop in ejection fraction (hrs-wks), pericardial effusion, chronic

heart failure

• Occurs 30 days – 1 year after treatment

• No specific therapy; supportive care

• Diuretics, digitalis, ACE-inhibitors, b-blockers

• Further use of anthracyclines is contra-indicated

19-9-2017