[Cardiac disease in patients with tumors and tumor therapy]

Cardiac disease may occur as direct complications of heart tumors or indirect complications of malignancies related to antineoplastic therapy. While primary cardiac neoplasias are rare, metastases to various cardiac structures are common. Cardiac tumors may cause a wide variety of clinical signs and symptoms. Benign myxomas are the most common primary tumors and often can be cured by total excision. Nearly all primary cardiac malignancies are sarcomas with a poor prognosis. The cardiotoxicity of anticancer agents can lead to significant complications that can affect patients being treated for various noncardiac neoplasias. Cancer treatment, most frequently anthracyclines, but also trastuzumab, cyclophosphamide and others may compromise cardiac function. The severity of such toxicity depends on many factors such as the molecular site of action, the immediate and cumulative dose, the method of administration, the presence of any underlying cardiac condition, and the patient's demographics. Moreover, toxicity can be affected by current or previous treatment with other antineoplastic agents or by concomitant irrradiation. Cardiotoxic effects can occur immediately during administration of the drug, or they may not manifest themselves until months or years after the patient has been treated. Radiation ports that include the heart may produce late coronary artery disease or constrictive pericarditis. Since cardiovascular disease and cancer are both common, precise knowledge of therapeutic interactions and complications is warranted.