Cardiooncology

Cardio-oncology is a medical discipline that focuses on the cardiovascular care of people with cancer. It addresses cardiovascular disease risk related to cancer therapies, as well as the long-term heart health of cancer survivors, with the aim of preventing, detecting, and treating therapy-associated heart disease while allowing effective cancer treatment.

The field brings together cardiologists, oncologists, radiologists, and other specialists to assess risk before and during cancer treatment, monitor heart function during therapy, and manage cardiovascular complications that arise during treatment and survivorship.

Cardiotoxicities include heart failure (reduced or preserved ejection fraction), myocardial infarction or ischemia, myocarditis, arrhythmias, pericardial disease, hypertension, and thromboembolic events. They can result from chemotherapies such as anthracyclines (e.g., doxorubicin), HER2-targeted therapies (trastuzumab), and several tyrosine kinase inhibitors, as well as from chest radiation and immune-mediated processes.

Assessment and surveillance involve baseline cardiovascular risk evaluation, imaging (echocardiography with ejection fraction and strain imaging; cardiac MRI when needed), and biomarkers such as troponin and natriuretic peptides. Monitoring frequency is tailored to the cancer therapy and patient risk.

Prevention and management include lifestyle measures and medical optimization (blood pressure, lipids, diabetes), use of cardio-protective drugs in high-risk settings (for example dexrazoxane with anthracyclines; ACE inhibitors or beta-blockers to prevent or treat left ventricular dysfunction), and adjustment of cancer therapy when necessary. Exercise and coordinated care are emphasized.

The field continues to evolve with guidelines from major societies and ongoing research into risk stratification, imaging techniques, and novel protective strategies. Cardio-oncology addresses both acute treatment-related toxicity and long-term cardiovascular health in cancer survivors.