If heart problems develop during cancer treatment

If you develop heart problems during or after cancer treatment, your doctors will talk to you about the best way to manage them.

Medicines are often used to treat heart problems. They may also be used to help protect your heart during cancer treatment. Your doctor or pharmacist can give you more information about your heart medicines.

Some conditions are treated with a heart procedure or surgery. This is always carried out by a specialist doctor, such as a cardiologist or a cardiothoracic surgeon. They will explain your treatment in detail, including possible risks and benefits.

If you are having cancer treatment when the heart problem starts, your cancer doctor may suggest changing your cancer treatment to prevent further damage to the heart. These changes may include:

  • stopping cancer treatment for a time
  • lowering the dose
  • changing to a different treatment that is less likely to cause heart problems
  • stopping cancer treatment completely.

What happens if heart problems develop?

If you develop heart problems during or after cancer treatment, your doctors will talk to you about the best way to manage them. Heart problems are often treated with medicines. Some conditions are treated with a heart procedure or surgery. 

Your cancer doctor may arrange for you to see a cardiologist (heart doctor) for advice. Some heart problems will be managed and monitored by your GP.

If you are having cancer treatment when the heart problem starts, your cancer doctor may suggest changing your cancer treatment to prevent further damage to the heart. These changes may include:

  • stopping cancer treatment for a time
  • lowering the dose
  • changing to a different treatment that is less likely to cause heart problems
  • stopping cancer treatment completely.

A routine echocardiogram and ECG showed problems with my heart. My treatment was stopped immediately and I was referred to a cardiologist who put me on medication.

Kyle


Heart medicines

Medicines are often used to treat heart problems. They may also be used to help protect your heart during cancer treatment. Your doctor or pharmacist can give you more information about your heart medicines. You can also get more detailed information from the British Heart Foundation.


ACE inhibitors

ACE inhibitors make your blood vessels relax and widen. This can lower your blood pressure. They are used to treat high blood pressure and heart failure. They are also used after a heart attack.

Examples are ramipril and lisinopril.

Angiotensin receptor antagonists (ARBs)

ARBs work in a similar way to ACE inhibitors. They relax and widen your blood vessels. They are used to treat high blood pressure and heart failure. 

Examples are candesartan and losartan.

Beta blockers

Beta blockers work by slowing your heart rate, which means your heart has less work to do. They can help control angina and reduce the risk of a heart attack in people who have already had one. They can also be used to treat abnormal heart rhythms and heart failure.

Examples are bisoprolol and carvedilol.

Cholesterol-lowering medicines

These medicines reduce the amount of cholesterol in the blood. This can reduce your risk of coronary heart disease, heart attack and stroke.

Examples are simvastatin and atorvastatin.

Diuretics (water tablets)

Diuretics make the kidneys to reduce the amount of fluid in the body. This can reduce the pressure on the heart muscle. They are used to treat heart failure, heart valve disease and high blood pres-sure.

There are different types of diuretics which work in slightly different ways. Your doctor or pharmacist can tell you more about the type of diuretic you are taking.

Examples are bumetanide and furosemide.

Anti-platelet medicines

These medicines help to make the blood less sticky and reduce the risk of clots forming. This means you are less likely to have a heart attack or stroke.

People who have a higher risk of heart attack or stroke may take these. This includes people with coronary heart disease, angina, or who have had a previous heart attack or stroke.

Some types of chemotherapy may cause a low level of platelets in your blood (cells that help your blood to clot). If your platelets are low, your cardiologist and cancer doctor may suggest you stop taking the anti-platelet medicine for a time. You will have regular blood tests to check your platelet levels.

Examples are aspirin and clopidogrel.

Anti-coagulants

Anti-coagulants prevent harmful blood clots from forming. They are most commonly prescribed for people who have an abnormal heart rhythm, or who have an artificial heart valve. 

Examples are wafarin and rivaroxaban.

I take eight medicines a day, but it is a small price to pay. They are helping to keep me healthy.

Kyle


Heart procedures and surgery

Some heart problems can be treated with a procedure or surgery rather than medicines. This is always carried out by a specialist doctor, such as a cardiologist or a cardiothoracic surgeon. They will explain your treatment in detail, including possible risks and benefits.

If coronary heart disease has caused narrow arteries and symptoms of angina, this can be treated with a procedure called angioplasty or with coronary bypass surgery.

During angioplasty, a small tube (stent) is put into the narrowed artery. The stent keeps the artery open. This lets blood flow through the artery and supply oxygen to the heart muscle.

Coronary bypass surgery involves bypassing the narrowed artery. The surgeon uses a small section of artery from another area of your body. They attach this above and below the narrow section of coronary artery.

If you have a heart valve problem, you may be able to have an operation to repair or replace the valve.

Some people have surgery to implant an electrical device to treat certain heart conditions. There are different types of device, including pacemakers and implantable cardioverter defibrillators (ICDs). These can help treat electrical problems such as abnormal heart rhythms or a slow heartbeat. Sometimes pacemakers are used to treat heart failure because they can help improve the pumping action of the heart.

You can find out more about different treatments on the British Heart Foundation website.

Heart procedures and surgery are not always possible. It can depend on the heart problem and your general health. Sometimes the risks of a procedure or surgery are too high. Your doctor may suggest heart medicines or healthy lifestyle changes instead.

British Heart Foundation logo.

Back to Cancer treatment and your heart

Tests to check heart health

There are several tests your doctors can use to check your heart function before, during and after treatment.