Chemotherapy & the Heart: Cardiotoxicity


Chemotherapy and other anti-cancer drugs are designed to combat cancer. With the increase in success of cancer therapies at treating cancer, we have found that these life-saving treatments can sometimes cause problems in the heart and vascular (circulation) system - called cardiotoxicity.

Cardiotoxicity can develop during cancer treatment - or - can occur within days or months or years after cancer treatment, once patients are cancer-free. Heart damage caused by chemotherapy-induced cardiotoxicity can reduce quality of life and increase the risk of death from cardiac-related causes.

Do all chemotherapy drugs cause cardiotoxicity?

No. But, it is important to ask yourself 2 questions?

  1. Do you have a history of heart disease?
  2. Do you have risk factors for heart disease?

Next, ask your doctor the following 2 questions:

  1. Does my treatment plan put me at risk for future heart damage (is it cardio-toxic)?
  2. Do you do use special testing to screen for heart problems before, during and after treatment?

The most common chemotherapy drugs related to cardio-toxicity include:

  • 5-fluorouracil (Adrucil)
  • Paclitaxel (Taxol)
  • Anthracyclines (a class of drugs)
  • Targeted therapies: such as monoclonal antibodies and tyrosine kinase inhibitors
  • Some Leukemia drugs

What is Cardio-Oncology?

A cardiologist and an oncologist working together can determine an individual patient's risk for cardiotoxicity by clinical examination and special testing before cancer treatment starts. If a patient is at risk, the cardiologist can implement measures to decrease this risk and alert the cancer doctor who will then select the most adequate anti-cancer therapy. If a patient starts to develop signs of cardiotoxicity during treatment, the cardiologist may treat the cardiotoxicity preventing the need to interrupt cancer treatment. In addition, the cancer doctor may alter the patient's treatment plan. The goal of the collaboration of a cardiologist and an oncologist in a discipline known as Cardio-Oncology, is to maximize the treatment of cancer while preserving cardiac function.


The Cardio-Oncology Center is a specialized center involving a multi-disciplinary group of specialists, including cardiologists, oncologists, cardiac surgeons and nurses from the Miller Family Heart, Vascular & Thoracic Institute and The Taussig Cancer Center who provide a comprehensive approach to evaluating, diagnosing and treating cardiotoxicity.


If you need more information, click here to contact us, chat online with a nurse or call the Miller Family Heart, Vascular & Thoracic Institute Resource & Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.

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Last reviewed by a Cleveland Clinic medical professional on 05/10/2019.


Bovelli D, Plataniotis G, Roila F and On behalf of the ESMO Guidelines Working Group. Cardiotoxicity of chemotherapeutic agents and radiotherapy-related heart disease: ESMO Clinical Practice Guidelines Ann Oncol (2010) 21 (suppl 5): v277-v282.

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