Chemo induced Congestive Heart Failure

jenjen

Hello everyone, I am new here and a survivor!. . I had Breast Cancer in 2009. Lumpectomy, Chemo and Radiation Treatment ended in January 2010. My cancer was in my lymph nodes even though it was still tiny so they felt in necessary to use the strong chemo. I am wondering if there are others out there that have been diagnosed with Chemotherapy induced congestive heart failure. I am a slim healthy (other than cancer and chf) 52 year old woman who has worked hard all her life. I had an ICD implanted in August for my damaged heart because of impending possible sudden death. I am on two heart meds plus... I have been looking for postings about the same thing and have not found any. Am I really the only one. They say there is bout 1-3% chance you can get chf from chemo.

jenjen

ok so I am thinking I really may be the only one whose Breast Cancer Chemotherapy treatement led to Congestive Heart Failure? Does anyone know of anyone else?  

Alpal

I just did a search and came up with over 500 hits. Top right hand side of page, hit search. Then put in congestive heart failure in the "key words" box. I seriously doubt you're the only one. Good luck to you, what a horrible side effect!

jancie

Jen - I had heart damage from the chemo and it is not so uncommon.   However, CHF and what I have are two different things.  I am not up to speed on heart issues.  I can just tell you that my ejection rate of my upper left and lower right ventricles are lower than they should be as those flap things aren't closing properly when my heart pumps so the blood gets sucked back in a little bit.

I am also on heart medication.  It sucks that I have to now see a cardiologist on a regular basis.

I wonder if the doctors can really pinpoint the heart damage as a result of chemo as Tamoxifen and Arimidex I believe both can cause heart problems and no doubt radiation to the left breast area can't be so great for your heart.  Do they really know or do they just want to blame chemo for everything?  I have no clue - I am just going with the flow for now.

Alpal

I did have cardiac vasospasms from both Gemzar and Xeloda. Not pleasant, but not CHF. Went away when I stopped Xeloda. Thank heavens!

ElenaMarie62

Dear Jen,

My brother had prostate cancer and was treated with a hormone drug, Lupron. He had very serious heart problems afterwards, to the point that he literally died and they had to revive him. He now has a pacemaker inserted under his skin. He also had radiation, but he swears that the Lupron was what really did him in.

When I was on Aromasin this past summer for 3 months, I was progressively getting worse, and could barely get up from a chair. When I told my oncologist, she told me I should have let them know I was suffering so much, but I was trying to at least make it on the drug for 3 months. She had me go immediately to see my cardiologist, because I had heart issues to begin with since having Rheumatic Fever when I was very young. My aortic valve is leaking, mildly, but it was still scary when she said I had to get my ticker checked out first and foremost.

So, I think these doctors know how dangerous the drugs, whether chemo drugs or the hormonal drugs, can be to other parts of our bodies.

I am now on Tamoxifen for the past 2 months, and so far, not having the aches and pains like I was on the Aromasin.

My husband lived for many years with Congestive heart failure, due to a bad heart, so as long as the drugs for the heart are working for you, I think it is fortunate that you are able to be helped by the heart medications.

My sister had ovarian cancer when she was 9 years old, and was given cytoxan for over a year, and vincristine also. Her heart has had damage to it, and she has to be checked out twice a year quite thoroughly and also takes heart medications. She is now 51 years old. Doctors at the time said she would only live about one year! Here we are, 42 years later!  

Best wishes, 

nancyh

Dear Jen,

I have a friend who had CHF post chemo/rads.  It was really rough, but she is doing well now and is very active.  I'm really sorry...I think we all look at the chemo side effects and think the really rare ones won't happen, but they do.  Hope you are doing okay,

NancyH 

rosemary-b

HI Jen

I had congestive heart failure from chemo and Herceptin. My ejection fraction was between 15 and 20 and I was on 4 heart meds. Now my ejection fraction is over 50. I was on 4 heart medications and have gradually gotten off of them as my heart got better. I see the cardiologist twice a year.

I have an ICD also and I think that is a real pain but I know I will change my mind if it saves my life.

jenjen

Hi Rosemary,

Thank you for posting. I loved reading that you got better and are off of meds. Can you tell me how long it took for you to go from 15-50? and how long after chemo did you get diagnosed. It was over a year after my chemo which included adriamycin that I was diagnosed and I was at 15%. With meds I am up to 20 and I agree about the ICD. My Dr.s say that my heart may not get better, I am so glad yours did. It gives me hope.

Thank you!

Jenny 

mks16

Jenny,

I am still awaiting more tests to find out the exact heart damage that I've experienced from chemo. Nobody actually told me it was from chemo, as I've had high blood pressure for many years., but many doctors I've seen suspect it. When my Oncologist ordered such strong chemo cocktail, he said I can take it because I am young and healthy and I brought up my blood pressure and he said it is of no concern because its well managed. They can't very well blame it on BP now either then. 

Yes, my blood pressure has always been well under control, I am only 38 years old and weigh 130 lbs (am 5'7" tall). I've been active throughout my chemo and radiation treatment, walking up to 5 miles five times a week and all the symptoms I experienced and complained to doctors about were dismissed as chemo fatigue. It was only at my pre-admission appointment that they realized I already suffered one silent heart attack with moderate damage to the inferior wall and that my heart is suffocating as its not getting enough blood. I am seeing a cardiologist for further tests in January... I live in Canada and things move slower here.

All this happened WHILE I was already taking Aspirin, beta blockers and ACE inhibitors (part of my blood pressure control). It frustrates me to tears to know that there is nothing I can do to get better because everything I did was for nothing, or at least was not good enough.

Rosemary's post gives me hope, no doctors want to discuss the reversibility of the damage at this point and I need something to hold on to. I agreed to all the cancer treatments doctors suggested, because I wanted to stay alive and lead a healthy life again, and because they told me I can take it.

jenjen

Hi mks16,

 Thank you for your post. I think we will both be aok. Even if it is not reversable, it can be treated with meds and diet. I was feeling worried because I had read a stupid book I won't even mention. I had a Dr. appoint today and they are going to watch me closely. I have the heart moniter that sends info to Dr. and I think everything will be great! I can't look back at the chemo as a bad thing because it saved my life. My best to you!  

Kay_G

jenjen, glad you are feeling better about things.  I had an ejection fraction of 45 when I had an echo at the end of November.  They are blaming it on herceptin, but I also had adriamycin which makes it more likely to get the damage from herceptin.  There is a thread in the herceptin forum called herceptin heart attack.  There are several of us there right now experiencing this.  I see your EF got much lower.  With herceptin, they give echos every 3 months, so mine got noticed right away.  I am still on herceptin, but also being watched very closely.  I also feel confident that everything will be okay.  Please feel free to join us on the herceptin heart attack thread even though your issue is from a different chemo.  I am sure you will be welcomed and we can all compare notes on how we are doing. I wish you the best and hope you are back to normal very soon.  I am also on two medications, a beta blocker and an ace inhibitor.  My problem is that my blood pressure is low to start with.  I am on a very low dose of the beta blocker and ace inhibitor, but can't take a higher dose because the cardiologist doesn't think I would tolerate it because of the low blood pressure.

SandiS

When I read your post, I felt like it was my story. I also had surgery, chemo and radiation. One lymph node was affected. One year after radiation i was diagnosed with heart failure. I also had a leaky valve that required open heart surgery. My ejection fraction was 20, so I now have an ICD. They said the muscle would never get better, but my last echo showed EF at 30. Before starting chemo my heart was checked and I was told it was healthy enough for chemo. What a shock to now have CHF.

boxerdoggirl

Same here-treatment in 2010 with ACT and now heart failure diagnosed this year.  On the meds.  No improvement in the last 3 months with EF but no worse (in the 30's).  I have always been very active and healthy and I feel so slowed down and anxious that my heart is not what it was.

Rowan47

Hi Ladies, so glad to have found this thread! I had 4 rounds of AC last year, and all was fine until a few months ago when I started getting shortness of breath. It has not got dramatically worse, but certainly no better. I seem to be yawning all day, just to get air into my lungs! I also get dizzy at times and my hands and feet are swollen. I went to my GP a few weeks ago and was sent for a chest x-ray (nothing suspicious found). She also gave me diuretics for the swelling (has helped). I had echo test b4 starting chemo last year, but nothing since. I was worried that I might have mets to my lungs, but after more research I think it more likely to be mild CHF. I also mentioned to my doc that I am unusually tired, and she said, "oh, we all get tired". Not helpful!! Anyway, just wondering what you think? Also, hope you are both doing well. Would love to hear from you.

Marcia1111

I have my exchange surgery next week and went to the doctor for pre-op medical clearance.  She said my EKG was abnormal and wants me to see a cardiologist.  She did give me medical clearance, but now I'm worried.  I don't know if she's looking at CHF or what, but did say that it could be from chemo.

Rowan47

Hi Marcia, sorry to hear this. When do you see cardiologist? Any other symptoms at all?

boxerdoggirl

I was not symptomatic for heart failure but have an arrythmia which is checked every year.  Went for my yearly cardiology check up in July of this year and had an abnormal EKG-Echo showed heart failure-I am now on a betablocker. an ARB (ace inhibitor gave me hives), lasix and recently the addition of digoxin as my EF dropped to 20 from 30 when I was initially diagnosed.  I had adriamycin, cytoxin, and Taxol in 2010.  All echos at that time were normal.

What a shock it was to get that diagnosis and a disappointment after going through the surgeries and the chemo and it's side effects to now have heart failure.  I continue to feel fine, work everyday, exercise and walk.  Just gotta keep on keepin' on.

Rowan47

Hi boxerdoggirl, glad to hear you are feeling fit, well etc. I am 48 and was quite fit, but now find it difficult to walk the few miles I try to every day. I opted for BMX instead of rads, and also declined the 4 months of taxol they recommended. I was trying to avoid long-term problems....yeah. Did you have a MUGA test? I had never heard of this test b4 researching CHF. Don't know if they use it here in New Zealand.

Marcia1111

Hi Rowan47, No other symptoms.  This came as quite a surprise.  I was cleared for surgery, but will have to investigate further.

boxerdoggirl

Hi Rowan,

Didn't have a MUGA  but had 3 echos-one before chemo, one midway through, and one at the finish of chemo-all fine.

divina913

Morning laddies...I also was diagnosed with CHF June 2012. Ended up in hospital for 3days!! EF was 25%. Prior to chemo my EF was 55%. Started chemo January 2012 & 5 months after I had CHF. To make matters worst....I was misdiagnosed with HER2+ in which I was actually HER2-!!! 1cm IDC/ lymph node negative!!! My EF now is up to 35-40% cardiologist thinks that since im not being exposed to Toxins anymore that my heart muscles are reviving...mine was due to Adriamycin/herceptin. ICD was also suggested by cardiologist but since EF went up...he didn't think it was necessary. We'll another echogram in cpl mos & see where we are. Im determined to reverse this CHF to normal!! I am on heart meds/tamoxifen.

Im so glad to be back here & share my journey with you ladies. At least I now feel im not alone & going crazy.

beth1965

Hi- my heart has been screwed up since chemo i am presently seeing a heart doctor now. He said there is definately damage from the chemo.

I was 46 and in perfect health (except for Cancer) when i got chemo. My chemo ended at the end of last summer and i have had constant problems.

It is not CHF that i know of but has been stated by heart specialist damage to my heart came from chemo

delaine

Hi

Have not posted in ages, more of a lurker but this topic caught my eye. I, too, am now having heart problems. My new PCP sent me for a routine ECG and it came back as abnormal. I had TC x4 chemo for ILC in 2009. Prior to cancer I had cardiac workup and was told my cardiac prognosis was very good. I was shocked when ECG came back as abnormal. Have since had two more ECGs, a treadmill test and scheduled for Echo and a myocardial perfusion test next month. Since I don't know yet what the problem is I cannot blame it on chemo but it seems odd to me that all of a sudden I now have this to worry about. Delaine

abowen

I was diagnosed with breast cancer in 2005.  I had two rounds of chemo, then was having radiation (left breast) and herception at same time.  Ended up with EF of 17.  With medication and working hard to do everything right I got back to EF of 55 in 2011.  Now (2013) I was feeling rough again.  It took a while to convince my heart MD that my fast pulse needed to be investigated.  My EF is back down to 20.  Having more tests next week.  I was wondering if any one else had experienced this relapse after getting so strong?  Amy

Tamkt130

My mother was diagnosed with Breast cancer in November 2001. She was diagnosed with CHF in May 2003. Her EF was 15-20 at the time of diagnosis. After medication she has done well. EF went up to 35-40 and she has done whatever she wanted to do. Now at the age of 69, she started having some shortness of breath and after a heart cath we were told that she has a EF of 10-15. Not sure what has changed. Cardiologist suggested a pacemaker/defibulator and a blood thinner. We have an appointment with a oncology cardiologist on Monday. She still cleans her house, works, grocery shops and other things she wants to do. If her EF is 10-15, I would think she would have trouble getting out of bed!

Holling

No, you're not the only one at all. Had treatment for Stage III breast cancer in 1996-1997. In 2001, I was diagnosed with CHF - ejection fraction 14. My EF climbed back to around 40, then this year fell to 24. I had an ICD implanted in May. I'm very discouraged but will keep on fighting. Grateful for the device. There's a chance my EF can go back up. I'm hopeful. In the meantime, it's exercise, stress reduction and healthy diet (except for the M&Ms I just ate). Best to you.

msfriz6

Hi everyone,

Add me to the list, thanks to Adriamycin. BMX, TAC, and rads - finished in '08. 3 years later at age 47, ended up Flight For Life, diagnosis dilated cardiomyopathy, and CHF. EF 10-15%. Prior to cancer treatment MUGA showed EF 67%.

Started on 5 meds, but had issues with low BP dropping even lower. Passed out several times, getting all banged up & terrifying my kids. 5 months passed, presented with A Fib and my EF did not improve so had a dual chamber pacemaker/defibrillator inserted under pec muscle because too thin to put under skin. After 14 months I was able to go off meds EF 45-50%. However, being drug free except for spironolactone, my ICD fired. Wanted me back on Amiodarone, which I refused. Ended up on Digoxin. After another 4 mo, fired again. Added Carvedilol for the 2nd time.

Through all this, I never really felt much better. Remained tired, short of breath with any kind of exertion & O2 would drop. Cardiologist kept saying my heart is scarred. GP finally listened and suggested a pulmonary work up. Amiodarone is known to be toxic to the lungs. Pulmonary function test showed small airway disease and hyperinflated lungs. Was negative for Amio Lung at this point, so they think lung issues due to Adriamycin as well. My O2 drops at night below 78, so I am on nocturnal 02.

My journey has been 2 years and 5 months and the battle still rages on. Lungs will most likely slowly deteriorate and heart damage will not regenerate. I am a shadow of my former self.... Married almost 24 years to a 4th generation farmer/rancher.... And raising 6 kids.....

2timer

I suppose that there is nothing one can do to prevent this from happening?

coolnurse

Hi Jen Jen,

My coworker and friend was just diagnosed with CHF resulting from her chemotherapy. She is only 37 years old and very afraid of what may happen next.

Kat1957

hi Jenjen, I'm new to this community, and read your post with interest. My low EF was discovered last summer at 25% on ECG, and I was symptom free. I had been treated since 2008 for atrial flutter, but that was discovered during my hysterectomy - again symptom free. My breast cancer was in 2006, and my heart issues are being attributed to adriamycin. My MRI showed slight scarring, and that's how my cardio electrophysiologist determined the cause. I'm curious how you are now, two years later. Did you get an ICD and did the beta blocker and the ace inhibitor help raise your EF?  I had an ablation a week and a half ago. My doctor is strongly encouraging me to get a defib/pacemaker device, as I have cardiomyopathy. No swelling or symptoms still - but low BP and the Coreg just drains me.  So hard to take, but I am. Also take lisinopril and digoxin and Eliquis. 

Anyway, your post sounded a little similar to my situation. I'm in good athletic shape too, but that doesnt seem to matter with chemo after-effects.  So...it's 2 years since you posted...how are you now?  Thank you and I hope that you'll report that all is well! 

And, a thank you to all of you ladies for posting and informing me, as I'm new to all this. How many of you have had ICD devices?  I'm fearful of getting one implanted, but the more I read about our after chemo heart issues, I'm prayerfully considering its necessary. I don't understand the chemo damaged heart - are we able to strengthen it, or will it continue to deteriorate? Thank you!