ESC 2022 Cardio-Oncology Guidelines: Paving the way for cardiovascular care through the minefield of cardiotoxicity in cancer survivorship


Take Home Messages
  • Cardiovascular disease is a prominent issue throughout cancer patients’ journeys from pre- therapy to long term post-therapy surveillance.
  • The development of newer cancer therapies is widening the range of possible treatment related cardiovascular toxicities which require a more personalized approach to surveillance and treatment.
  • Thorough risk assessment and early identification throughout the cancer treatment process is important in minimizing the impact of potential long term cancer therapy-related cardiovascular toxicity.
  • Conduction disorders, aortic regurgitation, coronary artery access and considerations of future approaches to repeat aortic valve intervention remain the key obstacles.
  • Data on optimal long-term surveillance for multiple therapies is still limited and requires further large extended studies to guide management as cancer survival continues to improve.

Cardiovascular disease (CVD) and cancer are two major causes of mortality worldwide (1). Chemotherapeutic agents have come a long way and the advent of targeted therapies has ushered in a new era of personalised cancer care which, along with risk factor reduction, have shown a decline in cancer mortality (2, 3). As cancer survival improves, the burden of CVD becomes more apparent (4). The Surveillance, Epidemiology and End Results (SEER) database showed that the risk of mortality from CVD was greatest in the first year of cancer diagnosis and patients diagnosed under 55 years old had a ten-fold risk of CVD related death compared to the general population (5).