Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
What Causes Cardiomyopathy In A Cancer Patient?
Question: What is prognosis for just being diagnosed by cardiologist with cardiomyopathy?
Brief Answer:
It depends upon type and severity
Detailed Answer:
Hello,
Welcome to Health Care Magic.
Thanks for writing.
I am Dr.Muhammad Ahmad. I have read your question completely, i understand your concern and will try to help you in best way possible.
Prognosis of cardiomyopathy depends upon the extent , severity and type of cardiomyopathy I would ask you to tell me all major and minor details related to the problem there can be cardiomyopathy due to your cancer drugs and it can be due to any other cause like heart attack or genetics.
So kindly tell me did you have heart attack or angina ever?
Why did you get an EKG? were you having any symptoms?
Are there any written notes by your doctor you might be having?
Did you get any echo before that? if yes then please tell me what did it say?
You listed your meds is this all you take?
Any heart issues before chemo?
I hope this answered your question.If you have more queries I am happy to answer.Otherwise rate and close the discussion
Regrads.
Dr.Muhammad Ahmad.
M.B.B.S(Licensed Family Physician)
Resident Cardiology.
It depends upon type and severity
Detailed Answer:
Hello,
Welcome to Health Care Magic.
Thanks for writing.
I am Dr.Muhammad Ahmad. I have read your question completely, i understand your concern and will try to help you in best way possible.
Prognosis of cardiomyopathy depends upon the extent , severity and type of cardiomyopathy I would ask you to tell me all major and minor details related to the problem there can be cardiomyopathy due to your cancer drugs and it can be due to any other cause like heart attack or genetics.
So kindly tell me did you have heart attack or angina ever?
Why did you get an EKG? were you having any symptoms?
Are there any written notes by your doctor you might be having?
Did you get any echo before that? if yes then please tell me what did it say?
You listed your meds is this all you take?
Any heart issues before chemo?
I hope this answered your question.If you have more queries I am happy to answer.Otherwise rate and close the discussion
Regrads.
Dr.Muhammad Ahmad.
M.B.B.S(Licensed Family Physician)
Resident Cardiology.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
No heart attack, no angina, no chest discomfort.
I have No immediate or extended family member with any heart problems of any sort.
Went to first cardiologist in November and did EKG and said I was fine. Went to be cleared for bariatric sleeve surgery. No heart symptoms.
Bariatric doctor did another EKG because my pulse was 130. Wanted to do a presurgery stress test (June). Didn't because of pulse. His EKG saw something abnormal. Didn't say what. Said to go to cardiologist. Original cardiologist had moved out of state. Went to a new one. He said pulse was 130 also and EKG showed cardiomyopathy. No heart problems before chemo except always had fast heartbeat....90 at rest, 120 when nervous or exercise, since first tested/brought to my attention at age 22. Have had no problems with my heart or energy before chemo. Have had numerous EKGs normal and before chemo had echos that were normal. Symptoms now are complete exhaustion from just walking from parking lot into building or walking through house or getting dressed, etc. Noticed it getting worse around January and just steadily worse, more weakness, fatigue, out of breath. Blamed my weakness on weak legs from neuropathy and fibromyalgia all this time.
No other meds except vitamins of vitamin D, B12, krill oil, and a multivitamin.
Sometimes aspirin or Advil for backache or headache.
Sometimes Xanax before a medical procedure (given that during cancer treatments)
Sometimes tramadol for slipped disk in lower back (maybe once a week)
Was given lisinopril and carvedilil during cancer treatment and for 2 years afterward and then doctor said it was no longer necessary and stopped it. So did not take for about a year.
GP also stopped my synthroid this past week since blood work seemed too high. Stopping it for a month for an "experiment" go back to her in one month. She does not know about this week's diagnosis of heart disease. Listening to heart by her seemed fine. Went to her for regular checkup to monitor thyroid and diabetes treatment. Blood pressure at all recent different doctor visits is ok. I did not mention to her how tired I am. I work very hard and was just blaming it on that and as I said my fibromyalgia and neuropathy along with my work. (I am the principal of a school).
I have No immediate or extended family member with any heart problems of any sort.
Went to first cardiologist in November and did EKG and said I was fine. Went to be cleared for bariatric sleeve surgery. No heart symptoms.
Bariatric doctor did another EKG because my pulse was 130. Wanted to do a presurgery stress test (June). Didn't because of pulse. His EKG saw something abnormal. Didn't say what. Said to go to cardiologist. Original cardiologist had moved out of state. Went to a new one. He said pulse was 130 also and EKG showed cardiomyopathy. No heart problems before chemo except always had fast heartbeat....90 at rest, 120 when nervous or exercise, since first tested/brought to my attention at age 22. Have had no problems with my heart or energy before chemo. Have had numerous EKGs normal and before chemo had echos that were normal. Symptoms now are complete exhaustion from just walking from parking lot into building or walking through house or getting dressed, etc. Noticed it getting worse around January and just steadily worse, more weakness, fatigue, out of breath. Blamed my weakness on weak legs from neuropathy and fibromyalgia all this time.
No other meds except vitamins of vitamin D, B12, krill oil, and a multivitamin.
Sometimes aspirin or Advil for backache or headache.
Sometimes Xanax before a medical procedure (given that during cancer treatments)
Sometimes tramadol for slipped disk in lower back (maybe once a week)
Was given lisinopril and carvedilil during cancer treatment and for 2 years afterward and then doctor said it was no longer necessary and stopped it. So did not take for about a year.
GP also stopped my synthroid this past week since blood work seemed too high. Stopping it for a month for an "experiment" go back to her in one month. She does not know about this week's diagnosis of heart disease. Listening to heart by her seemed fine. Went to her for regular checkup to monitor thyroid and diabetes treatment. Blood pressure at all recent different doctor visits is ok. I did not mention to her how tired I am. I work very hard and was just blaming it on that and as I said my fibromyalgia and neuropathy along with my work. (I am the principal of a school).
Brief Answer:
Chemo drugs seem to be culprit.Prognosis seems good.
Detailed Answer:
Hello,
Thanks for writing back,
I hope you have been having a great weekend.
I will hereby explain to you a few things in your case and how your prognosis is going to depend on some factors.
First of all let me explain to you what is meant by Cardiomyopathy, cardio-means heart and myopathy means -muscle disease, so myopathy means heart muscle problem.
Now there are many reasons to it like heart attack , diabetes, high blood pressure and many more but in your case according to your history and amazingly detailed responses, your cardiomyopathy is caused most probably by your cancer chemo drugs.
The most well-known cause of chemotherapy-induced cardio toxicity is DOXORUBICIN (ADRIAMYCIN)
Please check your chemo drug names and see if you are using this drug.
Now we come to prognosis , well If there was no problem on hearing and you are not having very severe symptoms, then there should be a mild disease and with mild disease your prognosis should be great. If this is controlled here it is a good 20+ year prognosis.
Here are some symptoms which show bad prognosis.
1) Shortness of breath which worsens on lying down.
2) Chest pain.
3) Increases heart beat 100+ at resting.
4) Swelling of legs.
5) Distended neck veins in general.
You don't seem to have them so i believe your problem hasn't reached any extreme.
WHAT SHOULD YOU DO:
1)Check the list of chemo drugs you are taking and read about them individually to see which might have been the culprit , you can discuss your drugs with me and I will tell you which might be causing it then you can discuss with your doctor to change or replace it.
2) Get your investigations specially the echo done this will be the definitive test to determined how much heart is working and how much is damaged because of the problem. I in your case expect a good heart in echo report I believe this can be recovered from.
3) After echo report discuss with your Cardiologist about further steps in treatment and management. Also coordinate with your cancer specialist to optimize the medicine and chemo drugs.
At the moment I would suggest you to keep calm, and get echo done as soon as possible this will be giving you a greater Insight into the prognosis and according to you history I believe it should be good.
You can discuss echo report with me any time at :
http://doctor.healthcaremagic.com/doctors/dr-muhammad-ahmad/69304
I Hope this answers your question, if your have more queries feel free to ask, otherwise close the discussion and rate it. Wish you the best of health.
Regards,
Dr.Muhammad Ahmad.(Licensed Family Physician)
M.B.B.S.
Resident M.D. Cardiology.
Chemo drugs seem to be culprit.Prognosis seems good.
Detailed Answer:
Hello,
Thanks for writing back,
I hope you have been having a great weekend.
I will hereby explain to you a few things in your case and how your prognosis is going to depend on some factors.
First of all let me explain to you what is meant by Cardiomyopathy, cardio-means heart and myopathy means -muscle disease, so myopathy means heart muscle problem.
Now there are many reasons to it like heart attack , diabetes, high blood pressure and many more but in your case according to your history and amazingly detailed responses, your cardiomyopathy is caused most probably by your cancer chemo drugs.
The most well-known cause of chemotherapy-induced cardio toxicity is DOXORUBICIN (ADRIAMYCIN)
Please check your chemo drug names and see if you are using this drug.
Now we come to prognosis , well If there was no problem on hearing and you are not having very severe symptoms, then there should be a mild disease and with mild disease your prognosis should be great. If this is controlled here it is a good 20+ year prognosis.
Here are some symptoms which show bad prognosis.
1) Shortness of breath which worsens on lying down.
2) Chest pain.
3) Increases heart beat 100+ at resting.
4) Swelling of legs.
5) Distended neck veins in general.
You don't seem to have them so i believe your problem hasn't reached any extreme.
WHAT SHOULD YOU DO:
1)Check the list of chemo drugs you are taking and read about them individually to see which might have been the culprit , you can discuss your drugs with me and I will tell you which might be causing it then you can discuss with your doctor to change or replace it.
2) Get your investigations specially the echo done this will be the definitive test to determined how much heart is working and how much is damaged because of the problem. I in your case expect a good heart in echo report I believe this can be recovered from.
3) After echo report discuss with your Cardiologist about further steps in treatment and management. Also coordinate with your cancer specialist to optimize the medicine and chemo drugs.
At the moment I would suggest you to keep calm, and get echo done as soon as possible this will be giving you a greater Insight into the prognosis and according to you history I believe it should be good.
You can discuss echo report with me any time at :
http://doctor.healthcaremagic.com/doctors/dr-muhammad-ahmad/69304
I Hope this answers your question, if your have more queries feel free to ask, otherwise close the discussion and rate it. Wish you the best of health.
Regards,
Dr.Muhammad Ahmad.(Licensed Family Physician)
M.B.B.S.
Resident M.D. Cardiology.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Herceptin taken for HER2 breast cancer (and taxol and adriamycin). No longer taking any cancer drugs. During chemo, doctors saw my heart function dropping, infarction rate down to 35%, at which time they put me on lisinopril and carvedilol, but continued chemo. Said it would go back to normal when chemo stopped. Chemo ended, and they said my heart was better but not totally good (don't know rate, they just said better) and was taken off both heart meds. Heart appeared ok for last couple years, even in EKG. Now suddenly not ok. I read online that herceptin can damage heart even years after stopping it. Must be what is happening to me. Various Online sites (Mayo clinic, government health sites) say I have a 5 year lifespan left, one site says maybe 10. Doesn't make me too happy :)
upon reading your list of symptoms to be concerned with, I do NOT have shortness of breath when lying flat down, I can sleep that way fine, have no chest pain at all, ever, no extended neck veins, or swollen feet. But I do have extreme shortness of breath with the tiniest bit of exertion (can no longer give tours at my school, breathless and must "recover" from just getting dressed, or other common small activity, cannot walk and talk at same time). And I have a rapid heart rate 120-130 even at rest. But not worse lying down. My echo and heart X-ray are scheduled July 9 and I meet cardiologist again on July 20, and he will have gathered up all my records from all different doctors. I got a refill (had it on file at pharmacy) on my lisinopril 10 mg yesterday and have started taking it again, not willing to wait until July 20 to have him say so and waste some time protecting my heart. I don't want to die from heart disease because I was trying not to die from cancer. Makes me angry, or frustrated, or something not good. My husband is so scared. I don't know how to help him. We thought we made it through cancer, so positive and "doing" whatever we were told, then plan the bariatric sleeve to get a jump start on losing weight (I weigh 266 and am 5'7"), to get more healthy, and doctor said losing weight would likely rid me of diabetes (also got that during chemo), and now find I cannot have the bariatric surgery because of my heart problem. I am now "pretending" I had the surgery and can only eat a tiny bit at a time, protein first, protein shakes, etc, no sugar, no simple carbs. My school needs me (I am the founder), and my family needs me, we had our 34 year old son die 2 years ago, and I don't think my husband and other sons can take much more if I would die short of old age. I mean that would suck, right? Chemo is evil. Now I just must do all I can to heal this heart if at all possible.
upon reading your list of symptoms to be concerned with, I do NOT have shortness of breath when lying flat down, I can sleep that way fine, have no chest pain at all, ever, no extended neck veins, or swollen feet. But I do have extreme shortness of breath with the tiniest bit of exertion (can no longer give tours at my school, breathless and must "recover" from just getting dressed, or other common small activity, cannot walk and talk at same time). And I have a rapid heart rate 120-130 even at rest. But not worse lying down. My echo and heart X-ray are scheduled July 9 and I meet cardiologist again on July 20, and he will have gathered up all my records from all different doctors. I got a refill (had it on file at pharmacy) on my lisinopril 10 mg yesterday and have started taking it again, not willing to wait until July 20 to have him say so and waste some time protecting my heart. I don't want to die from heart disease because I was trying not to die from cancer. Makes me angry, or frustrated, or something not good. My husband is so scared. I don't know how to help him. We thought we made it through cancer, so positive and "doing" whatever we were told, then plan the bariatric sleeve to get a jump start on losing weight (I weigh 266 and am 5'7"), to get more healthy, and doctor said losing weight would likely rid me of diabetes (also got that during chemo), and now find I cannot have the bariatric surgery because of my heart problem. I am now "pretending" I had the surgery and can only eat a tiny bit at a time, protein first, protein shakes, etc, no sugar, no simple carbs. My school needs me (I am the founder), and my family needs me, we had our 34 year old son die 2 years ago, and I don't think my husband and other sons can take much more if I would die short of old age. I mean that would suck, right? Chemo is evil. Now I just must do all I can to heal this heart if at all possible.
Brief Answer:
Thing's aren't that grim
Detailed Answer:
Hello ,
Thanks for writing back,
I have read your response closely I do understand your concern and psychologically the condition you are in , physical and mental trauma of a cancer then fighting it, all thet strength it takes mentally and physically to fight it off , the fears, anxieties, nightmares and long time spent in the struggle of fighting it and then eventually succeding in it but getting you heart effected, I can understand how helpless angry and broken one can feel.
But well that's how it has happened now lets talk what best you can do in this situation.
1) Sleve surgery :
You wanted to get it but now you can't , it's ok if not a jump start, you can get your weight down gradually and with a courageous person like you it shouldn't be a big deal, weight reduction will help your symtpoms too, will reduce work load on your heart and your problems will get better. So lets not worry about this, if you don't eat unhealthy and high calorie food you wont gain weight and you will end up losing it.
2) Cardiomyopathy:
Herceptin and Adriamycin can both cause damage to heart, but herceptin induced cardiomyopathy is usually reversible improves with time and adriamycin induced problem depends upon dose of adriamycin and damage to the heart.
At your stage when there is no sign of heart failure one can survive easily for years and years ...survival also dpends upon your general health... a person with weak body and other issues will survive less compared to an otheriwse healthy person with same extent of heart problem.
Final diagnosis and expected prognosis of heart problem is only going to be made on Echo cardiography.If it comes out to be good and your heart is working better than 40-45% then you will be all good to live another 15 years withour real issues but yes you will have to take meds for a long time.
If your heart beat is 120 at rest I would suggest my similar patients to use carvedilol as well so that heart slows down and it's work load gets reduced to make it's survial better. Licinopril is going to help you too.
3) You family:
I am sorry to know about your son's death but that's how life is and I would suggest you not to think alot about the problem because this anxiety is going to put more pressure on your heart, just try to relax and hope for the best,
But without any doubts final opinion will be by you cardiologist as he will be having all your records and his patient with him ,
END NOTE:
Survival years on websites are better interprestted by doctor because they depends upon many things, the drug that caused it, Heart failure vs no heart failure ..severe vs subclinical disease. So you don't have to worry about that for know your echo report will give us a better idea of the extent of problem , treatment options and prognosis.
If you get an echo report before your doctor's visit you can always contact me and discuss this report with me at
http://doctor.healthcaremagic.com/doctors/dr-muhammad-ahmad/69304
I am open to further queries if any if you want to discuss meds or symptoms of a bad heart or any thing at all you can feel free to ask.
I will be pleased if that puts your mind to some rest.
Stay blessed.
Regards .
Dr.Muhammad XXXXXXX
Thing's aren't that grim
Detailed Answer:
Hello ,
Thanks for writing back,
I have read your response closely I do understand your concern and psychologically the condition you are in , physical and mental trauma of a cancer then fighting it, all thet strength it takes mentally and physically to fight it off , the fears, anxieties, nightmares and long time spent in the struggle of fighting it and then eventually succeding in it but getting you heart effected, I can understand how helpless angry and broken one can feel.
But well that's how it has happened now lets talk what best you can do in this situation.
1) Sleve surgery :
You wanted to get it but now you can't , it's ok if not a jump start, you can get your weight down gradually and with a courageous person like you it shouldn't be a big deal, weight reduction will help your symtpoms too, will reduce work load on your heart and your problems will get better. So lets not worry about this, if you don't eat unhealthy and high calorie food you wont gain weight and you will end up losing it.
2) Cardiomyopathy:
Herceptin and Adriamycin can both cause damage to heart, but herceptin induced cardiomyopathy is usually reversible improves with time and adriamycin induced problem depends upon dose of adriamycin and damage to the heart.
At your stage when there is no sign of heart failure one can survive easily for years and years ...survival also dpends upon your general health... a person with weak body and other issues will survive less compared to an otheriwse healthy person with same extent of heart problem.
Final diagnosis and expected prognosis of heart problem is only going to be made on Echo cardiography.If it comes out to be good and your heart is working better than 40-45% then you will be all good to live another 15 years withour real issues but yes you will have to take meds for a long time.
If your heart beat is 120 at rest I would suggest my similar patients to use carvedilol as well so that heart slows down and it's work load gets reduced to make it's survial better. Licinopril is going to help you too.
3) You family:
I am sorry to know about your son's death but that's how life is and I would suggest you not to think alot about the problem because this anxiety is going to put more pressure on your heart, just try to relax and hope for the best,
But without any doubts final opinion will be by you cardiologist as he will be having all your records and his patient with him ,
END NOTE:
Survival years on websites are better interprestted by doctor because they depends upon many things, the drug that caused it, Heart failure vs no heart failure ..severe vs subclinical disease. So you don't have to worry about that for know your echo report will give us a better idea of the extent of problem , treatment options and prognosis.
If you get an echo report before your doctor's visit you can always contact me and discuss this report with me at
http://doctor.healthcaremagic.com/doctors/dr-muhammad-ahmad/69304
I am open to further queries if any if you want to discuss meds or symptoms of a bad heart or any thing at all you can feel free to ask.
I will be pleased if that puts your mind to some rest.
Stay blessed.
Regards .
Dr.Muhammad XXXXXXX
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
