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Late Effects of Treatment for Childhood Cancer (PDQ®): Treatment - Patient Information [NCI] - Cardiovascular System

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Childhood cancer survivors who received radiation or certain chemotherapy drugs are at risk of late effects to the heart and blood vessels. These include the following:

  • Abnormal heartbeat.
  • Weakened heart muscle.
  • Inflamed heart or sac around the heart.
  • Damage to the heart valves.
  • Coronary artery disease (hardening of the heart arteries).
  • Congestive heart failure.
  • Chest pain or heart attack.
  • Blood clots or one or more strokes.
  • Carotid artery disease.

Possible signs and symptoms of heart and blood vessel late effects include trouble breathing and chest pain.

These and other signs and symptoms may be caused by heart and blood vessel late effects or by other conditions:

  • Trouble breathing, especially when you are lying down.
  • Heartbeat that is too slow, too fast, or different from the heart's normal rhythm.
  • Chest pain.
  • Swelling of the feet, ankles, legs, or abdomen.
  • When exposed to cold or having strong emotions, the fingers, toes, ears, or nose become white and then turn blue. When this happens to the fingers, there may also be pain and tingling.
  • Sudden numbness or weakness of the face, arm, or leg (especially on one side of the body).
  • Sudden confusion or trouble speaking or understanding speech.
  • Sudden trouble seeing with one or both eyes.
  • Sudden trouble walking or feeling dizzy.
  • Sudden loss of balance or coordination.
  • Sudden severe headache for no known reason.

Talk to your child's doctor if your child has any of these problems.

Certain tests and procedures are used to detect (find) and diagnose health problems in the heart and blood vessels.

These and other tests and procedures may be used to detect or diagnose heart and blood vessel late effects:

  • Physical exam and history: An exam of the body to check general signs of health, including checking the heart for signs of disease, such as abnormal heart beat or anything else that seems unusual. A history of the patient's health habits and past illnesses and treatments will also be taken.
  • Electrocardiogram (EKG): A recording of the heart's electrical activity to evaluate its rate and rhythm. A number of small pads (electrodes) are placed on the patient's chest, arms, and legs, and are connected by wires to the EKG machine. Heart activity is then recorded as a line graph on paper. Electrical activity that is faster or slower than normal may be a sign of heart disease or damage.
  • Echocardiogram: A procedure in which high-energy sound waves (ultrasound) are bounced off the heart and nearby tissues or organs and make echoes. A moving picture is made of the heart and heart valves as blood is pumped through the heart.
  • Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs such as the heart and make echoes. The echoes form a picture of body tissues called a sonogram. The picture can be printed to be looked at later.
  • Lipid profile studies: A procedure in which a blood sample is checked to measure the amounts of triglycerides, cholesterol, and low- and high-density lipoprotein cholesterol in the blood.
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