Gloria Iliescu

Cancer as a Risk Factor for Cardiovascular Disease

Improvements in early diagnosis and cancer treatments have contributed to high survival rates for many cancer patients. However, these patients often die of cardiovascular disease rather than recurrence of their cancer. Heart disease manifesting after cancer may be due to several mechanisms: shared cardiovascular risks between cancer and cardiovascular disease, inflammatory states associated with malignancies, and/or cardiotoxic effects of cancer therapy. Cancer treatment increases the risk of cardiovascular diseases directly by damaging critical structures of the heart or indirectly by promoting accelerated atherosclerosis. Estimating cardiovascular risk by using advanced imaging and monitoring of the cardiac biomarkers can be used for early detection and treatment of subclinical cardiac injury. Better knowledge of these early and late cardiac effects in cancer patients will enable adoption of both primary and secondary prevention measures of long-term treatment complications in cancer survivors.

Echocardiography and Fluoroscopy-Guided Pericardiocentesis for Cancer Patients With Cardiac Tamponade and Thrombocytopenia

Thrombocytopenia has been considered a relative contraindication to pericardiocentesis; limited data are available regarding the safety of the procedure in thrombocytopenic patients. The incidence of refractoriness to platelet transfusion defined as failure to increase by at least 10,000/μl after

Ischemic Heart Disease: Special Considerations in Cardio-Oncology

Opinion statementThe interplay and balance between the competing morbidity and mortality of cardiovascular diseases and cancer have a significant impact on both short- and long-term health outcomes of patients who survived cancer or are being treated for cancer. Ischemic heart disease in patients with cancer or caused by cancer therapy is a clinical problem of emerging importance. Prompt recognition and optimum management of ischemic heart disease mean that patients with cancer can successfully receive therapies to treat their malignancy and reduce morbidity and mortality due to cardiovascular disease. In this sense, the presence of cancer and cancer-related comorbidities (e.g., thrombocytopenia, propensity to bleed, thrombotic status) substantially complicates the management of cardiovascular diseases in cancer patients. In this review, we will summarize the current state of knowledge on the management strategies for ischemic disease in patients with cancer, focusing on the challenges encountered when addressing these complexities.

CARDIAC CATHETERIZATION IN CANCER PATIENTS WITH THROMBOCYTOPENIA: 4-YEAR EXPERIENCE FROM A HIGH VOLUME CANCER CENTER CARDIAC CATHETERIZATION LABORATORY

Thrombocytopenia is common in certain types of cancer. Research data and guidelines about PCI in this subgroup of patients is scarce as cancer patients have been excluded from all major PCI clinical trials. Between 11/2009 and 11/2013 a total of 1,517 consecutive cancer patients underwent cardiac