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Related Concept Videos

Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

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Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
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Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

790
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
790
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

632
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
632
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

805
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
805
Cardiomyopathy VI: Nursing Management01:29

Cardiomyopathy VI: Nursing Management

481
Assessment: Nursing management of patients with cardiomyopathy begins with a thorough assessment of the patient's history, including a family history of cardiomyopathy or sudden cardiac death, personal history of heart disease, hypertension, diabetes, and any alcohol consumption or drug use.During the physical examination, assess vital signs, look for signs of heart failure (such as edema, jugular venous distention, and cyanosis), auscultate for abnormal heart sounds (like murmurs and gallops),...
481
Heart Failure VII: Nursing Interventions01:30

Heart Failure VII: Nursing Interventions

787
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
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Cancer therapy-induced left ventricular dysfunction: interventions and prognosis.

Akanksha Thakur1, Ronald M Witteles2

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Early cardiac intervention improves left ventricular ejection fraction (LVEF) in cancer patients experiencing LVEF decline due to chemotherapy. Most patients achieve recovery and can continue cancer treatment.

Keywords:
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Area of Science:

  • Cardiology
  • Oncology
  • Pharmacology

Background:

  • Cardiotoxicity is a dose-limiting side effect of many chemotherapeutics, causing significant morbidity and mortality.
  • Early detection and intervention for cardiac dysfunction are crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the impact of cardiac interventions on left ventricular ejection fraction (LVEF) decline in cancer patients.
  • To assess the rate of LVEF recovery and the ability of patients to continue cancer therapy following intervention.

Main Methods:

  • Retrospective review of 247 patients referred for cancer therapy-associated cardiac abnormalities.
  • Analysis of 79 patients with LVEF decline linked to cancer therapeutics, including baseline characteristics, cardiac imaging, and medications.
  • Documentation of clinical course and cardiac interventions received.

Main Results:

  • Common malignancies included breast (46%) and hematologic (35%). Primary agents causing LVEF decline were anthracyclines, trastuzumab, and TKIs.
  • Mean LVEF decreased from 60% to 40% post-therapy. Interventions included beta-blockers (84%) and ACE inhibitors/ARBs (83%).
  • Mean LVEF recovered to 53% post-intervention; 77% achieved LVEF recovery to ≥50%, with 68% recovering within 6 months. 76% continued cancer therapy.

Conclusions:

  • Cardiac interventions effectively improve LVEF in cancer patients experiencing therapy-induced cardiotoxicity.
  • The majority of patients can achieve significant LVEF recovery and successfully complete their planned cancer treatment.