Cancer therapy–related cardiac dysfunction refers to weakening or damage to the heart that may occur as a side effect of certain chemotherapy drugs, targeted therapies, immunotherapy, or radiation treatment. While modern cancer therapies have significantly improved survival, some treatments can affect the heart muscle, heart valves, blood vessels, blood pressure, or heart rhythm.
Some patients receiving cancer therapy may develop reduction in heart pumping function, heart failure, breathlessness, swelling, fatigue, palpitations, high blood pressure, or rhythm disturbances. The risk may be higher in patients with previous heart disease, diabetes, hypertension, obesity, smoking history, older age, or prior chest radiation exposure. In many cases, early heart damage may occur silently without symptoms initially, making regular monitoring very important.
Prevention begins with detailed cardiac evaluation before starting cancer treatment. Baseline assessment may include ECG, echocardiography, strain echocardiography (GLS strain imaging), blood pressure evaluation, blood tests, and assessment of cardiovascular risk factors. Identifying high-risk patients early helps guide safer treatment planning and closer monitoring throughout chemotherapy.
Regular cardiac monitoring during treatment helps detect early changes in heart function before significant damage develops. Serial echocardiography and strain imaging are especially useful for identifying subtle heart muscle dysfunction at an early stage. In selected patients, advanced imaging techniques such as cardiac MRI, PET, SPECT, or MUGA scans may also be used for detailed evaluation of heart function and chemotherapy-related cardiac injury.
Control of cardiovascular risk factors plays a major role in prevention. Proper management of blood pressure, diabetes, cholesterol, obesity, smoking cessation, healthy diet, regular exercise, and stress reduction all contribute to better cardiovascular protection during cancer treatment.
Treatment of cancer therapy–related cardiac dysfunction depends on the severity and type of cardiac involvement. Some patients may require heart failure medications, blood pressure control, rhythm management, or cardioprotective therapies to preserve heart function. In selected cases, chemotherapy dosage may need adjustment or temporary modification under close coordination between the oncology and cardiology teams.
Modern cardio-oncology care focuses on both successful cancer treatment and preservation of long-term heart health. With early monitoring, advanced imaging, preventive strategies, and timely treatment, many patients can safely continue cancer therapy while minimizing the risk of serious cardiac complications and maintaining better quality of life.
ESC
