Lecture link https://youtu.be/zj5D7Lv8sXM

1. Ahmed Elborae
Assistant lecturer of Cardiology
Cairo University
Top highlights

3. Clinical scenarios
 60 year old female patient, receiving HER2i therapy, FU echo
revealed drop of EF% from 60 % to 45 %, should we continue ?
70 year old male patient, known metastatic lung cancer, presenting
with inferior STEMI, what to do?
20 year old male patient, receiving Immune check point inhibitor
therapy, presenting with shortness of breath, what is the next step?

4. 3 main stations
RF
CVD

5. 1-

6. HFA-ICOS Risk score

7. 1ry&2ry prevention

8. You will never be surprised !
2- Surveillance during therapy

9. Chemo-Therapy Related Cardio-Toxicity spectrum
(CTRCT)
Anthracycline
HER2i &PI ICI& Chimeric T cell 5FU-Platinum-VEGFi Radiotherapy
Radiotherapy
Nilotinib&ponatinib
Dasatinib
VEGFi& PI
VEGFi& PI
Vandetanib (QTC)

10. 1- Anthracycline
CTRCD

14. 2-HER2i
CTRCD

15. Clinical scenarios
 60 year old female patient, receiving HER2i therapy, FU echo
revealed drop of EF% from 60 % to 45 %, should we continue ?
70 year old male patient, known metastatic lung cancer, presenting
with inferior STEMI, what to do?
20 year old male patient, receiving Immune check point inhibitor
therapy, presenting with shortness of breath, what is the next step?

17. 3-Fluropyrimidine
Coronary artery disease

18. Clinical scenarios
 60 year old female patient, receiving HER2 therapy, FU echo
revealed drop of EF% from 60 % to 45 %, should we continue ?
70 year old male patient, known metastatic lung cancer, presenting
with inferior STEMI, what to do?
20 year old male patient, receiving Immune check point inhibitor
therapy, presenting with shortness of breath, what is the next step?

21. 4-VEGFi (Avastin)
Systemic HTN
HF-VTE-ATE
QTc↑

24. QTc 500
At baseline: Don’t start
At FU: Stop

25. 5-(BCR-ABL) Dasatinib
Pulmonary HTN
Nilotinib-Ponatinib
PAD (HTN-DM-Dyslipidemia)

26. 5-(BCR-ABL) Dasatinib
Pulmonary HTN
Nilotinib-Ponatinib
PAD (HTN-DM-Dyslipidemia)

28. 6-Proteasome inhibitors
HF-AF
VTE
HTN

29. 6-Proteasome inhibitors
HF-AF
VTE
HTN

30. Plt < 50.000
GIT or GUT cancer
Plt < 25.000
Recent major bleeding
Brain metastasis

34. 7-ICI (Nivulumab)
Myocarditis

35. Clinical scenarios
 60 year old female patient, receiving HER2 therapy, FU echo
revealed drop of EF% from 60 % to 45 %, should we continue ?
70 year old male patient, known metastatic lung cancer, presenting
with inferior STEMI, what to do?
20 year old male patient, receiving Immune check point inhibitor
therapy, presenting with shortness of breath, what is the next step?

37. 8-Chimeric antigen T cell therapy (Kymriah)
Cytokine storm > Myocarditis (IL-6)

38. 3-Risk stratification at the end of therapy

39. During the 1st year after the end of therapy

40. Long term FU after the end of therapy

43. Thank You