Clinical Cases in Cardiology
Series Editors: Ravi V. Shah · Siddique A. Abbasi · James L. Januzzi
Atooshe Rohani
Clinical Cases in
Cardio-Oncology
,Clinical Cases in Cardiology
Series editors:
Ravi V. Shah
Boston, MA, USA
Siddique A. Abbasi
Providence, RI, USA
James L. Januzzi
Boston, MA, USA
,Clinical cases are a key component in modern medical ed-
ucation, assisting the trainee or recertifying clinician to
work through unusual cases using best practice techniques.
Cardiology is a key discipline in this regard and is a highly
visual subject requiring the reader to describe often very sub-
tle differences in the presentation of patients and define ac-
curately the diagnostic and management criteria on which to
base their clinical decision-making.
This series of concise practical guides is designed to
facilitate the clinical decision-making process by reviewing a
number of cases and defining the various diagnostic and
management decisions open to clinicians.
Each title will be illustrated and diverse in scope, enabling
the reader to obtain relevant clinical information regarding
both standard and unusual cases in a rapid, easy to digest
format.
More information about this series at http://www.springer.
com/series/14348
,Atooshe Rohani
Clinical Cases in
Cardio-Oncology
,Atooshe Rohani
Northern Ontario School of Medicine
Thunder Bay, ON
Canada
ISSN 2523-3009 ISSN 2523-3017 (electronic)
Clinical Cases in Cardiology
ISBN 978-3-030-71154-2 ISBN 978-3-030-71155-9 (eBook)
https://doi.org/10.1007/978-3-030-71155-9
© The Editor(s) (if applicable) and The Author(s), under exclusive license to
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,Clinical Cases in Cardio-Oncology is a great
clinical reference for internists, cardiologists, and
oncologists. I started practicing in the cardio-
oncology field in beautiful Northwestern Ontario,
Canada around 3 years ago. It was a new field for
me and challenged me in many ways. I thoroughly
enjoy practicing in this field and I hope by writing
this book, I can share my expertise with my
colleagues across the globe especially for early-
career cardiologists and anyone wanting to start
work in this very interesting field. I was inspired
by and very appreciative of one of my first patients
when I asked her for consent to share her clinical
data in my book. She replied with an emphatic
yes! She said she would do anything to help other
cancer patients across the world. I remember on
that day I felt so blessed to be her cardiologist on
the challenging journey of breast cancer treatment.
Gratefully I would find that all my patients were
very willing to give consent to use their data. This
book is because of them.
,Contents
1 Introduction����������������������������������������������������������������������� 1
2 Dasatinib Induced Pleural Effusion and
Pulmonary Hypertension������������������������������������������������� 3
3 Ponatinib Induced Stroke ����������������������������������������������� 11
4 Nilotinib Induced Peripheral Artery
Occlusive Disease������������������������������������������������������������� 15
5 Imatinib Cardiotoxicity ��������������������������������������������������� 17
6 Doxorubicin Induced Heart
Failure with Reduced Ejection Fraction ����������������������� 21
7 Trastuzumab-Related Cardiotoxicity����������������������������� 29
8 Rituximab, Doxorubicin or Cancer
Induced Tachycardia��������������������������������������������������������� 33
9 Carfilzomib (CFZ) Induced Heart
Failure with Reduced Ejection Fraction ����������������������� 37
10 Immune Checkpoint Inhibitor
Cardiovascular Toxicities������������������������������������������������� 41
11 Androgen Deprivation Therapy Cardiotoxicity����������� 49
12 5-FU Induced Atrial Fibrillation in the
Context of Ischemic Heart Disease ������������������������������� 53
13 Cisplatin Induced Acute Coronary Syndrome ������������� 59
14 Radiotherapy and Valvular Heart Disease ������������������� 63
,viii Contents
15 Acute Coronary Syndrome in a Patient with
Lung Cancer 2 Days After Second
Cycle of Carboplatin and Paclitaxel������������������������������� 67
16 Ibrutinib and Cardiac Arrythmias���������������������������������� 71
17 Dual Therapy BRAF Inhibitor Chemotherapy
(Dabrafenib + Trametinib Chemotherapy)
Induced Peripheral Edema ��������������������������������������������� 75
18 Vascular Endothelial Growth Factor (VEGF)
Bevacizumab and Hypertension������������������������������������� 79
19 Amyloid Heart Disease��������������������������������������������������� 83
20 Venous Thromboembolism in Cancer Patients������������� 89
21 QT Prolongation in Cancer Patients ����������������������������� 97
22 Cardiovascular Implantable
Electronic Devices (CIEDs) in cancer
Patients Needs Radiation Therapy��������������������������������� 103
23 Atrial Fibrillation in Cancer Patients����������������������������� 107
24 Pericardial Disease in Cancer Patients��������������������������� 111
25 Large Cardiac Mass, an Incidental
Finding in a Patient with Breast Cancer������������������������ 115
Index����������������������������������������������������������������������������������������� 119
,List of Abbreviations
ACEI Angiotensin converting enzyme
inhibitor
AF Atrial fibrillation
AHA American Heart Association
ARB Angiotensin receptor blocker
ASCO American Society of Clinical
Oncology
ASE American Society of
echocardiography
AVRT Atrioventricular reentrant
tachycardia
BB Beta-blocker
BMI Body mass index
BNP B-type natriuretic peptide
BPM Beats per minute
CABG Coronary artery bypass graft
CAD Coronary artery disease
CCS class Canadian Cardiovascular Society
grading of angina pectoris
CHF Congestive heart failure
CIED Cardiovascular implantable elec-
tronic devices
CML Chronic myelogenous leukemia
cMRI Cardiac magnetic resonance
imaging
CPAP Continuous positive airway
pressure
CRP C-reactive protein
CTO Chronic total occlusion
, x List of Abbreviations
CVD Cardiovascular disease
DCM Dilated cardiomyopathy
DOAC Direct oral anticoagulant
DVT Deep vein thrombosis
FDA Food and Drug Administration
FOLFIRI chemotherapy FOL—folinic acid (leucovorin),
F—fluorouracil (5-FU),
IRI—irinotecan
FOLFOX Folinic acid (leucovorin) “FOL”,
Fluorouracil (5-FU) “F”, and
Oxaliplatin (Eloxatin) “OX”
GI Gastrointestinal
GLS Global longitudinal strain
Gy Gray
HF Heart failure
HFmrEF Heart failure with midrange
ejection fraction
HFpEF Heart failure with preserved
ejection fraction
HFrEF Heart failure with reduced ejec-
tion fraction
HTN Hypertension
ICD Implantable cardioverter-
defibrillator
ICI Immune checkpoint inhibitors
IMiD Immunomodulatory drug
LAD Left anterior descending artery
LCX Left circumflex artery
LMWH Low molecular weight heparin
LV Left ventricle
LVEF Left ventricular ejection fraction
MCA Middle cerebral artery
mmol/L Millimoles per litre
MUGA Multigated acquisition
NSTEMI Non-ST-elevation myocardial
infarction
NT-proBNP N-terminal pro–B-type natri-
uretic peptide