Cause of Cardiotoxicity

The Process

Cardiotoxicity is damage to the cardiac muscle inhibiting the normal function of the heart. It is commonly seen with chemotherapy and medications taken to control existing diseases. The physiological mechanisms of cardiotoxicity are not completely understood. What is known is that an overabundance of free radicals leads to oxidative stress causing the death of cardiac muscle cells. A minor loss of left ventricle pumping efficiency causes shortness of breath. More serious cases can result in congestive heart failure (CHF), heart attack, or death.

Causes

The anthracyclines class of drugs, used in cancer treatment, cause cardiotoxicity. In cancer treatment the anthracyclines are commonly combined with other medications that contribute to heart damage. Radiation therapy to the chest and heart area damages coronary blood vessels. Patients receiving drug and radiation therapy are at an even greater combined risk for cardiotoxicity. Recreational drugs, chemicals, and environmental agents are also known causes of cardiotoxicity.

Symptoms

Cardiotoxicity renders the heart unable to efficiently pump blood throughout the body. Symptoms of this effect include shortness of breath, fatigue, and anemia. These signal that the heart is having difficulty maintaining its essential function. If at risk for CHF symptoms include chronic coughing, swelling of the ankles and feet, and weight gain. These signal that the heart is not beating correctly and therefore failing.

Prevention

The risk and degree of cardiotoxicity from the anthracyclines are correlated with a lifestyle dose response. If the administered doses are minimized so is the cardiotoxicity. Antioxidant and iron chelating drugs clear free radicals and can help prevent cardiotoxicity. A low sodium diet, like the Dietary Approaches to Stop Hypertension (DASH diet), lowers the workload of the heart making it more efficient. Appropriate and tolerable exercise strengthens the heart muscle promoting healthy oxygen and blood flow.

Treatment

Cardiotoxicity is treated by maintaining and improving efficient function of the heart. ACE inhibitors, beta-blockers, diuretics, and vasodilators are common heart medications used to help the heart overcome cardiac muscle damage. Sometimes the causal treatments can be adjusted, stopped, or changed to restrict further damage. Diet and exercise can also be utilized, like in prevention, to further help the heart function at its best.

Considerations

Modifying causal treatments or skipping medications can increase risk for cardiotoxicity. Lifestyle modifications like exercise and dieting may not be appropriate for everyone. The symptoms of cardiotoxicity, especially in cancer treatment, are also associated with other side effects and health problems. Always consult your physician for diagnosis, information about holistic and alternative therapy, and changes to the treatment plan.