Evaluation and Long-Term Outcomes of Cardiac Toxicity in Paediatric Cancer Patients

Abstract

Paediatric cancer survival rates have increased dramatically in the last 20 years. With decreased mortality comes increased long-term morbidity. Cardiovascular disease is the leading cause of secondary morbidity and mortality of childhood cancer survivors. The most common chemotherapeutic agents in treatment regimens are implicated in chemotherapy-induced cardiomyopathy. The clinical presentation is rarely uniform and may manifest in symptoms besides chest pain, shortness of breath or decreased exercise tolerance. In addition to symptomatic patients, asymptomatic patients are especially important to screen as the efects of cardiac toxicity are reversible if caught early. There are new techniques more sensitive than traditional 2D echocardiography ejection fraction that may lead to earlier detection of cardiac dysfunction. Treatment methods have changed litle in the recent past with the exception of miniaturization of support devices allowing for cardiac recovery or bridge to cardiac transplant.