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Related Concept Videos

Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

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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...
354
Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

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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,...
427
Cardiomyopathy I: Introduction and Classification01:25

Cardiomyopathy I: Introduction and Classification

465
Cardiomyopathy, or CMP, is a group of diseases affecting the myocardial structure, impairing its ability to pump blood effectively. This condition can lead to arrhythmias, heart failure, or sudden cardiac death.Cardiomyopathies are classified into primary and secondary categories:Primary Cardiomyopathy refers to conditions involving only the heart muscle that are often idiopathic (of unknown cause) or genetic. They primarily affect the myocardium without the involvement of other systemic...
465
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

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Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
417
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

305
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...
305
Cardiomyopathy VI: Nursing Management01:29

Cardiomyopathy VI: Nursing Management

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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),...
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Trastuzumab-Induced Cardiomyopathy.

Rachel Barish1, Emily Gates2, Ana Barac3

  • 1MedStar Georgetown Physicians Group, Division of Cardiology, 3800 Reservoir Road Northwest 5PHC, Washington, DC 20007, USA.

Cardiology Clinics
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Summary

Trastuzumab improves HER2-positive breast cancer outcomes but can cause heart failure. Monitoring cardiac function is crucial, with treatment adjustments recommended for left ventricular dysfunction.

Keywords:
Breast cancerCardiooncologyCardiotoxicityGastric cancerHeart failureHuman epidermal growth factor 2 (HER2)

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Area of Science:

  • Oncology
  • Cardiology
  • Pharmacology

Background:

  • Human epidermal growth factor receptor 2 (HER2) overexpression in 25% of breast cancers correlates with aggressive disease.
  • Trastuzumab is a targeted therapy significantly improving outcomes for HER2-positive breast cancer patients.
  • Trastuzumab therapy is linked to cardiotoxicity, including left ventricular dysfunction and heart failure.

Purpose of the Study:

  • To review the role of trastuzumab in cancer treatment.
  • To elucidate the mechanisms of trastuzumab-induced cardiotoxicity.
  • To discuss recent clinical findings and ongoing controversies regarding trastuzumab's cardiac effects.

Main Methods:

  • Literature review of trastuzumab's efficacy and cardiotoxicity.
  • Summary of clinical guidelines for cardiac monitoring during trastuzumab therapy.
  • Analysis of recent research on HER2-targeted therapy cardiotoxicity.

Main Results:

  • Trastuzumab offers substantial benefits in HER2-positive breast cancer.
  • Left ventricular dysfunction is a significant adverse effect requiring monitoring.
  • Recommendations include holding or stopping trastuzumab if cardiac dysfunction occurs.

Conclusions:

  • Trastuzumab is vital for HER2-positive breast cancer but necessitates careful cardiac surveillance.
  • Understanding and managing trastuzumab-induced cardiotoxicity is critical for patient safety.
  • Ongoing research addresses the balance between oncologic benefit and cardiac risk.