Common heart problems linked to cancer and its treatment

Problem

What it means

Risk may increase with some types of:

When fats or other substances build up in the blood, blood vessels can become blocked (atherosclerosis). This can reduce the amount of blood flowing through the heart. It may cause:

• angina – pain or tightness in the chest when not enough blood is flowing to the heart. This needs to be checked because it may also be a symptom of a heart attack
• heart attack – pain in the chest due to permanent damage to the heart. This needs emergency treatment.

• chemotherapy
• immunotherapy
• radiation therapy to the chest for certain cancers

Blood clots are clumps of blood that can block blood vessels. They may cause serious conditions including:

• stroke – when the blocked blood vessel restricts blood flow to the brain (called an ischaemic stroke). Strokes can also be caused by bleeding in the brain if an artery leaks or splits (called a haemorrhagic stroke)
• pulmonary embolism (PE) – when a blood clot blocks the supply of blood to the lungs; this can be life-threatening
• deep vein thrombosis (DVT) – when a blood clot forms in a deep vein, often in the leg; can lead to pulmonary embolism.

• cancer
• chemotherapy
• hormone therapy
• immunotherapy
• ports, etc.
• radiation therapy to the chest for certain cancers (may increase stroke risk, not PE or DVT)
• surgery targeted therapy

Damage or weakening of the heart muscle (cardiomyopathy) may mean the heart becomes too weak to pump blood around the body properly. This can cause shortness of breath and fatigue. Cardiomyopathy must be treated quickly to prevent it becoming permanent.

• chemotherapy
• immunotherapy
• radiation therapy to the chest for certain cancers
• targeted therapy

When the heart muscle (myocardium) becomes inflamed (swollen or irritated) it can affect the heart’s ability to pump blood. This may cause chest pain, shortness of breath and rapid or irregular heartbeats, and can be life-threatening if not treated early.

• immunotherapy
• radiation therapy to the chest for certain cancers

The heart has an electrical system that tells it to beat. If this system is not working properly, it can lead to a heartbeat that is irregular (beating too fast or too slow). This is called arrhythmia. For example, atrial fibrillation (AF) is an irregular heartbeat that is often faster than usual. Arrhythmia can cause you to be light-headed or dizzy and, in some cases, to faint. It may also be a sign of heart attack, heart failure or heart inflammation (myocarditis, see above).

• chemotherapy
• immunotherapy
• radiation therapy to the chest for certain cancers
• targeted therapy

other cardiovascular concerns

Cancer treatments may also affect the heart by causing:

• high blood pressure (hypertension) – when the force of the blood pushing against the artery walls is too high for a long time or the arteries become stiff, the heart has to work harder to pump blood. This increases the risk of heart attack and stroke
• high cholesterol (hyperlipidaemia) – a build-up of fats (lipids) in the blood. This increases the risk of heart attack, stroke and kidney damage
• high blood sugars (hyperglycaemia) – when there is too much glucose (sugar) in your blood. This increases the risk of heart attack, angina and stroke.

See your GP for regular check-ups for these issues.

• chemotherapy
• hormone therapy (e.g. androgen deprivation therapy)
• immunotherapy
• targeted therapy