Intersection of cardiology & oncology clinical practices

Globally, cancer and cardiovascular disease are the top two causes of mortality causing approximately 1.2 million deaths annually. The incidence of cancer is expected to increase globally as the population ages and due to lifestyle changes. The prognosis of cancer patients has improved over the last few decades primarily because of newer chemotherapeutic drugs, but many of these newer drugs have unexpected cardiotoxic side effects. These side effects may impact the oncological prognosis by compelling a reduction in dose of chemotherapy or even discontinuation of the treatment. The cardiotoxic effects of cancer treatments will become an important issue contributing to mortality and morbidity as cancer survivorship increases. Currently, echocardiographic evaluation of ejection fraction is the most commonly employed diagnostic test used to detect and predict cardiac toxicity due to chemotherapy. Studies have proven that newer techniques assessing myocardial mechanics, such as strain imaging or speckle track imaging, are much better in predicting early changes in the heart when compared to conventional echocardiographic parameters. Cardiologists working collaboratively with oncologists can improve the outcomes of these patients by early detection and early treatment of cardiac and vascular complications due to chemotherapy, thereby reducing long-term morbidity and mortality.