ABSTRACT
Since the recognition of congestive heart failure owing to anthracycline cardiotoxicity, cardiologists and oncologists have collaborated to balance the benefit of cancer treatment against the risk of cardiotoxicity in order to achieve optimal health outcomes in cancer patients. The contemporary cancer treatment landscape has become more complex, as novel oncological therapies permit long-term survival even in advanced stage cancer, but with potential cardiovascular risk related to certain therapeutic classes. In addition to therapy-related cardiotoxicity, older patients are receiving cancer therapy and living longer, leading to increased concern about cardiovascular toxicity. Cardiovascular risk management has emerged as an important aspect of contemporary cancer care. In this chapter, cases from contemporary cardio-oncology practice are used to introduce aspects of cardiotoxicity risk stratification. The application of clinical risk factors, cardiac biomarkers, and cardiac imaging to cardiovascular risk assessment are reviewed and an integrated approach to cardiovascular risk stratification is presented. Finally, an appreciation of global cardiovascular risk assessment in the cancer patient is discussed and an approach to risk stratification for non-left ventricular (LV) dysfunction related cardiac complications is presented.
