Cardiovascular System

Summarize

Key points

Long-term effects on the heart and blood vessels are more likely to occur after treatment for certain childhood cancers;

Radiation to the chest and certain types of chemotherapy increase the risk of long-term effects on the heart and blood vessels;

Long-term effects on the heart and blood vessels can lead to certain health problems;

Symptoms and signs caused by long-term effects of the heart and blood vessels;

Tests used to detect and diagnose health problems of the heart and blood vessels.

Epidemiological

not have

Etiology/ Risk factors

Other risk factors

Autonomous therapy has been around for a long time.

There are risk factors for high blood pressure or other heart disease, such as a family history of heart disease, being overweight, smoking, high cholesterol, or diabetes. When these risk factors come together, the risk of long-term effects is even higher.

The thyroid gland produces less than normal levels of thyroid hormone, growth hormone or sex hormones

Possible health problems

Abnormal heartbeat
The heart muscle weakens
Myocarditis or pericarditis
The heart valve is damaged
Coronary artery disease (hardening of the arteries in the heart)
congestive heart-failure
Chest pain or heart attack
Blood clots or one or more strokes
carotid disease

Classification & Staging

Cancer types

Acute lymphoblastic leukemia (ALL)
Acute myeloid leukemia (AML)
Brain and spinal cord tumors
Head and neck cancer
Hodgkin's lymphoma
Non-Hodgkin's lymphoma
Wilms' tumour
Cancer treated with stem cell transplants.

Clinical Manifestations

sings and symptoms

Breathing difficulties, especially when lying down
The heartbeat is too slow, too fast or different from the normal rhythm of the heart
Chest pain
Swollen feet, ankles, legs or abdomen
When exposed to cold or strong emotions, fingers, toes, ears or nose turn white and then blue. When this happens on the fingers, there is also pain and tingling
Sudden numbness or weakness in the face, arm or leg (especially on one side of the body)
Sudden confusion or difficulty in speaking or understanding language
Sudden difficulty seeing with one or two eyes
Suddenly have difficulty walking or feeling dizzy
Sudden loss of balance or coordination
Sudden severe headache, cause unknown

If your child has any of these problems, please consult your child's doctor.

Clinical Department

not have

Examination & Diagnosis

test mode

Physical examination and medical history: Examine general signs of health, including checking for signs of heart disease, such as abnormal heartbeats, high blood pressure or other abnormalities. Learn about the patient's health habits and past illnesses and treatments.

Electrocardiogram (EKG): This device records the electrical activity of the heart to check the heart rate and rhythm. Electrodes are placed on the patient's chest, arms, and legs, and connected to an ECG machine via wires. The heart's electrical activity is then recorded as a line graph on paper. Abnormal electrical activity, either faster or slower than normal, may indicate heart disease or damage.

Echocardiography: The process of reflecting high-energy sound waves (ultrasound) from the heart and nearby tissues or organs and producing echoes. When blood is pumped through the heart, the heart and heart valves form a moving picture.

Ultrasound examination: The process of reflecting high-energy sound waves (ultrasound) to internal tissues or organs (such as the heart) and producing echoes. The echoes form an image of body tissue called an ultrasound image. This image can be printed out for later viewing.

Blood lipid test: The process of measuring triglycerides, cholesterol and low-density lipoprotein cholesterol in the blood.

Talk to your child's doctor about whether your child needs a checkup to see if there are signs of heart and blood vessel abnormalities. If so, what is the frequency of the checkup.

Clinical Management

therapeutic tool

Radiation to the chest, spine, brain, neck, kidneys or whole body (TBI as part of a stem cell transplant). The risk of problems depends on the body area exposed to radiation, the dose given, and whether the radiation is delivered in small or large doses.

The total dose of certain types of chemotherapy and anthracyclines: Chemotherapy with anthracyclines (such as doxorubicin, epirubicin, idoxuridine, and epirubicin) and anthraquinones (such as mitoxantrone) increases the risk of heart and vascular issues. The risk depends on the total dose of chemotherapy and the type of drugs used. It also depends on whether a drug called dexrazoxane is used during anthracycline therapy. Dexrazoxane can help reduce heart and vascular damage after 5 years of treatment. Cyclophosphamide, methotrexate, and platinum-based chemotherapies (such as carboplatin and cisplatin) may also cause long-term effects on the heart and blood vessels.

Stem cell transplantation.

Nephrectomy (surgery to remove all or part of a kidney)

Accepting radiation therapy to the heart or blood vessels and certain types of chemotherapy are the biggest risk factors.
New therapies that reduce radiation doses and use low-dose chemotherapy or use low-dose harmful chemotherapy drugs may lower the risk of long-term effects on the heart and blood vessels compared to previous treatments.

Prognosis

not have

Follow-up & Review

not have

Daily Care

Prevention and health care

Children who recover from cancer may reduce their risk of long-term effects on the heart and blood vessels through a healthy lifestyle, including:

A healthy weight
Diet that is good for heart health
Regular exercise
Smoking

Cutting-edge therapeutic and clinical Trials

not have

References

data source ：

PDQ Pediatric Treatment Editorial Board. PDQ Late Effects of Treatment for Childhood Cancer. Bethesda, MD: National Cancer Institute. Website: https://www.cancer.gov/types/childhood-cancers/late-effects-pdq. Date accessed: July 24,2018. [PMID: 26389365]

Translated by Qian Yueping (Senior Manager, Medical Device Industry, Medical Clinical Affairs Department, PhD in Biology)