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Late Effects of Treatment for Childhood Cancer (PDQ®)

  • Posted: 04/23/2004
  • Updated: 08/18/2014

Table 2. Cardiovascular Late Effects

Predisposing Therapy  Potential Cardiovascular Effects Health Screening 
DOE = dyspnea on exertion; SOB = shortness of breath.
Anthracyclines (daunorubicin, doxorubicin, idarubicin, epirubicin); mitoxantroneCardiomyopathy; arrhythmias; subclinical left ventricular dysfunctionHistory: SOB, DOE, orthopnea, chest pain, palpitations
Cardiovascular exam
Echocardiogram or other modality to evaluate left ventricular systolic function
Electrocardiogram
Laboratory: lipid profile, consider troponin or brain natriuretic peptide (BNP) level
Radiation impacting the heartCongestive heart failure; cardiomyopathy; pericarditis/pericardial fibrosis; valvular disease; atherosclerotic heart disease/myocardial infarction; arrhythmiaHistory: SOB, DOE, orthopnea, chest pain, palpitations
Cardiovascular exam: signs of heart failure, arrhythmia, valve dysfunction
Echocardiogram or other modality to evaluate left ventricular systolic function
Electrocardiogram
Laboratory: lipid profile
Radiation impacting vascular structuresCarotid or subclavian artery diseaseHistory: transient/permanent neurological events
Blood pressure
Cardiovascular exam: peripheral pulses, presence of bruits
Neurological exam
Carotid ultrasound
Laboratory: lipid profile
Plant alkaloids (vinblastine, vincristine)Vasospastic attacks (Raynaud’s phenomena); autonomic dysfunction (e.g., monotonous pulse)History: vasospasms of hands, feet, nose, lips, cheeks, or earlobes related to stress or cold temperatures
Exam of affected area
Electrocardiogram
Platinum agents (cisplatin, carboplatin)DyslipidemiaFasting lipid profile