Anthracyclines and HER2-directed agents carry a known risk of cardiac dysfunction. A baseline echocardiogram, ECG and cardiovascular risk review before treatment allow early detection and timely heart failure therapy.
Surveillance frequency depends on baseline risk and cumulative dose.
- Record LVEF, ideally with global longitudinal strain where available.
- Check blood pressure, lipids and glucose; treat risk factors before therapy starts.
- Note cumulative anthracycline dose in the record.
- Refer early to cardiology if ejection fraction falls during treatment.
Why it matters
Without a baseline, early cardiotoxicity cannot be recognised and treated before it becomes heart failure.
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