Certain chemotherapy drugs can damage the heart. The most common ones are the anthracyclines, such as daunorubicin and doxorubicin, but other drugs may cause heart damage, too. This occurs in about 1 in 10 people who receive these drugs and usually involves damage to the heart muscles.
If the heart is damaged by chemotherapy, it may not be able to pump blood through the body as well as it did before treatment. This can lead to fluid build-up and other problems known as congestive heart failure.
You may notice these symptoms:
- Puffiness or swelling in the hands and feet (fluid retention)
- Shortness of breath that gets worse with exercise or lying flat
- Dizziness
- Erratic heartbeat
- Dry cough
If you have had radiation to the mid-chest area, pre-existing heart problems, uncontrolled high blood pressure, or if you are a smoker, you will be at higher risk for heart damage.
Often, before the doctor starts chemotherapy with a drug that can cause heart damage, they will check your heart function to make sure that there are no major problems. Your heart function will also be checked during treatment to ensure that no changes have occurred. Tests such as an electrocardiogram (EKG), an echocardiogram, or a MUGA scan may be done to check for heart changes. An electrocardiogram records the heart’s electrical impulses, while an echocardiogram is an ultrasound of the heart. With a MUGA scan, you are given a radioactive substance that a special scanner traces through your heart to tell how well your heart is pumping.
If problems develop, the chemotherapy drug will be stopped to prevent further permanent damage. Tell your doctor or nurse right away if you notice changes in your heart rhythm, shortness of breath, weight gain, or fluid retention.
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