Chemo induced Congestive Heart Failure

Just came across this thread while researching for an article on heart damage due to chemotherapy.  Seems the doctors don't want to alarm people when they start them on chemo but it would make sense to give a forewarning so people can decide for themselves. 

My daughter was never told of the risk. She complained of shortness of breath but was told it was just fatigue from the treatment.  She complained more and her oncologist reluctantly called a cardiologist at the same hospital and sent her upstairs. The cardiologist told her - so you think the chemo is hurting your heart.  He listened to her heart  did some tests called her and told her all was fine and go see a psychiatrist. 

Long story short - her story on is on the Jesicha's Hope site - but she died about six months later and not until recently did we discover the tests had shown damage and one nurse told us they knew she was not going to make it.

We need to ask questions and never take no for an answer, second opinions are important. 

Thanks for the thread. 

My mother was diagnosed with breast cancer in Aug of 2009. She was recently told she has CHF and COPD. She too had 4 cycles of the red devil. Now she has had heart issues sense she was 52. She had her aortic heart valve replaced. I questioned her doctor that did her chemo have anything to do with his, immediate answer was NO, it happens right away if it was brought on by the chemo. Does anyone know if this is true? She is now 78 almost 79 and I see her failing.

I'm sure you are right. I had sent my mom on a mini vacation in early October to see my sister in NE. They then drove to Chicago to go see my sisters daughter and children (my mom never got to meet her great grandchildren) and hasn't seen her grandchildren in 9 years. Thought it would be a time to make memories. One day of being in Chicago she ended up in the hospital with CHF and COPD and phonemia. She was in the hospital for 8 days and then back to my sisters daughter house to rest a few days before I could fly her back home. Guess it wasn't much of a vacation but when she was in the hospital I requested to be on the phone while the doctors came in to talk with my mom and sister. ( I take care of my mom alone sense my sister is in NE and brother is in Washington state). I had asked the doctors if they felt this could have come on due to the chemo (CHF). He didn't even let me get all the words out and he was saying NO. It would have happened much sooner. Another thing is she never had any cardiac work up done prior to chemo or after. After reviewing her records I found that it was 9 years sense her last work up. So I have had to educated myself (with much help of this board) about BC. I have now had to learn more about all her new conditions. My mother is so important to me and I plan to have her around for a long time. Thank you all for all the information and I continue to learn.

Hi jenjen,

Congratulations on your survivorship sister! I had breast cancer in 2005.  I had the same treatment as you; lumpectomy, aggressive chemo, radiation, and adjuvant hormone treatment with Tamoxifen (could only handle it for two years due to its side effects).

I had a muga scan of the heart before and after treatment. Everything was fine. My oncologist closed his practice and moved to another state after a 5 practice in Illinois. Then I lost my health insurance so I never followed up with another oncologist although I doubt he/she would have suggested paying attention to my heart after so many years. 

This March (a month before my 53rd birthday) I ended up in the ER with congestive heart failure. My arteries were clear, I did not have a heart attack, always had low blood pressure, no family history and normal cholesterol levels. After the initial shock of this new diagnosis, Adryamiacin came to mind. I mentioned it to the cardiologists and they passively agreed it could have had an effect on my heart. 

I know it had an affect on my heart. Yes I was told there was a slight chance of this happening but at the time I didn't know if I would die or survive. 

Perhaps the chemo bought me 9 more years, but if I had to do it over again, I would have had the mastectomy. Chemo has so many side effects even years later and if it wasn't for forums like this, finding information about this is hard to come by.

Hugs and prayers to you Jen and all the survivors out there.  Stay strong!

Hi all!

I wondered if anyone could say what your symptoms were before being dx with CHF. I did have the MUGA test before treatment, and only ended up taking one ACT chemo treatment before I decided the risk/benefit ratio was not worth it (I as stage 1, but with a second, smaller tumor found in an MRI the day before surgery). I then did 2 years Tamoxifen, went through menopause and finished with 3 years of Aromasin.

A medical student detected a murmur while I was at my oncologist many years ago. The onc agreed, and I was sent for an immediate echo, but all was good and no one has heard the murmur since. I have actually gotten WORSE (even more fatigue) after stopping the Aromasin. I began to have migraines (with aura...which involves a temporary loss of some cognitive functions, visual disturbances, numbness in tongue/mouth, etc.).  And now I am so fatigued I've had to close my business of 20 years and have no income. I am dizzy when sitting up or standing. And I've been dx with a vestibular nerve problem which was used to explain my dizziness (I don't have extremely high or low BP, but it varies a LOT). No blood sugar problems. 

I had a CT lung screening recently and they did find some very small nodules on one side (largest was only 5mm, very common in our Midwest area as histoplasmosis, indeterminate, non-calcified)-and I am going to a pulmonologist but cannot get in until August (about 8 more weeks). 

I had my peripheral arteries checked and they're fine. A couple of years ago I checked for narrowing of arteries in heart and they're fine.  But I cannot walk up ONE flight of stairs without extreme exhaustion.  Bending over or squatting down has me gasping for air.  I can no longer care for my yard, and I have trouble even dusting.  I just ran the sweeper in one room and I was drenched in sweat.  I'm fine when lying down or sitting, but I cannot take ANY exertion or heat at all. So I came to these boards to find out WHAT symptoms finally got a doctor to take you seriously enough to check your heart.  

Hugs and best wishes to all.

"Whatnow"

Well I see it is almost a year later since you posted. Interestingly, I finished radiation therapy in September, took Tamoxifen for three months after finishing rads, out of the blue I ended up in the hospital with Congestive Heart Failure at the end of November. I now have Atrial Fibrillation as well, which has converted to normal. I am on Warfarin and two other heart meds, one for fluid on the lung and the other to slow the heart rate. I was referred to a cardiologist, nothing showed up on the echocardiogram that day, I also did fine on the treadmill. he found it puzzling! As do !!

I am 53 and 11 years out from my DX - received dose dense ACT, radiation (to the left side), and 5 years of Tamoxifen. Side effects (body aches/fatigue/swelling) have worsened over time, but all doc's kept saying - get out and move, there's nothing wrong.  Developed heart arrhythmias about 2 years ago and now all of a sudden the onc says - yes, they are finding heart issues with patients 10 or more years out.  My last echo showed ejection rate down to 50% (10% less than 2 years ago).  Am wondering if anyone here could recommend a site which would show cardiologists who specialize in chemo-radiation induced heart issues.  Need to find someone in the Pennsylvania/New Jersey area. My last cardiologist told me my salt intake was too low (this without even doing a blood test), and recommended I eat salty potato chips! Definitely need to find a new cardiologist!

Hi Ladies, I too have chemo induced heart damage. I have 2 Cardiologist, daily meds twice a day, and a new ECHO every three months to monitor my heart. My EF has dropped to 46%, down from a baseline of 55%. Adriamycin is the culprit. I cannot have any more of it ever. The additional worries, costs, and tests is just another little side effect I guess. My MO looked at me like I was a mad woman when I told her what happened, and of course she said it wasn't possible. Really?? I am left in a hard place because I am triple negative as well so the options are few to begin with. After all this, I hate to think I am going to die from a heart attack..............

That's me, DD AC/T and heart damage. Tired, short of breath, meds twice a day, and a lot of extra appointments and bills to go with! You? I did find out that there are a lot of us..............thanks chemo!

Hi Michele, My current drug list is:

Gabapentin 330 mg twice a day for neuropathy

Losartan 25 mg once a day

Carvedilol 6.25 twice a day

Other than Biotin that is all I am willing to do. I'm sick of eating enough meds to be called lunch. I have shortness of breath that is a PITA in the summer with the humidity. Cooler temps are far better for me. My Cardiologist told me that it would get better also, but sadly waiting for that to happen. Some days I have a racing pulse but it usually goes away pretty quick, mostly it happens when I am stressed out and tired. I still struggle with fatigue, sleeping for 12 - 24 hours on my days off. My job is very physical and lots of stress so I'll deal with that after the New Year. Maybe a change is in order for me to live like I want to instead of sleeping my days off.

I see my Cardiologist every three months but he won't order any tests or a new ECHO unless something changes. My EF is 46%. But holding steady so I am hopeful. It could be so much worse. I just hate the fatigue, it rocks my world in a very bad way. Let me know what the results are, and I hope you have great news!! Cheryl

Dionne1-

We are so, so sorry to hear about this. You're right, it is incredibly unfair! This is an older topic but hopefully our reply here will bump it to the top and you'll get some feedback from the community, and also support as you go through this!

The Mods

Hello, So, I am a 52 year old female.Had the chemo "cocktail" a/c 15 years ago and just last week, found out I have chemo enduced heart failure. Now I start these scarey cardio drugs to see if they help, if not more tests and god knows what. The chemo weakened my heart muscle and I have a low ejection fraction....and valve regurgitation....

I'm 6.5 years out from treatment & have developed heart issues. I had A- fib in April, & was in heart failure at that time, though the cardiologist said that I don't have congestive heart failure now. I do, though, have mitral valve damage & regurgitation & am looking at open heart surgery for replacement & possibly a bypass. I do blame my treatment, I had left sided radiation. Now I read that open heart surgery is risky for the radiated heart. The whole thing is very concerning & totally unexpected.

I'm so sorry to hear about your dx. It's a double whammy after going through breast cancer. About 3 and 1/2 yrs after chemo- Adriamycin/Cytoxin I was being treated for bronchitis for two weeks before a correct dx. My EF was 15. I could only sleep sitting straight up in a chair because my lungs were so filled with fluid I couldn't breath. I took a diuretic, went through cardio rehab, started taking the three chf drugs and got a defib/pacemaker. I started working out, changed my diet and in 2013 my EF was 50-60. I watch my sodium intake and any drastic changes in weight. I don't think about it anymore except for the meds and cardio visits. After my dx, my dad got chf. He developed kidney failure and was hoping for a heart transplant. Instead he got an LVAD. It extended his life 2 yrs - prostrate cancer metastasized and ended his life. He had a very good attitude about the LVAD and actually helped others who got LVADs. I don't see chf as a death sentence. I have other health issues that make life much more difficult than chf. The. ICD is simply a safety net, but I don't think about it. "get it and forget it." I know it's very scary. Make sure you have the best cardiologists. I've had this since 2005 and I'm 52. Im about to get my device exchanged because the battery life ran out. It has never paced or cardio converted my heart. My faith in God and prayer plays a huge role in everything. Hang in there! I hope this helps

I, too, developed congestive heart failure due to chemo.  I am a survivor who did not complete chemo as a result. I was diagnosed in April 2012, had lumpectomy in May 2012; chemo and radiation followed. By December 2012 I had developed CHF.  I am alive and well with no evidence of cancer.  I am only on high blood pressure meds which I was taking prior to my DX.