What is often associated with cardiovascular complications?

• A. Radiation therapy
• B. Immunotherapy
• C. Surgery
• D. Chemotherapy

Answer: (D)

Chemotherapy is often associated with cardiovascular complications because several chemotherapy agents can directly affect the heart. For example, anthracyclines such as doxorubicin can cause dose-dependent damage to heart muscle, leading to cardiomyopathy and heart failure. Other drugs, like trastuzumab, can impair cardiac contractility, especially when used with anthracyclines. The underlying mechanisms involve oxidative stress, mitochondrial injury, and disruption of cardiomyocyte signaling, with risk increasing with higher cumulative doses and in patients with preexisting cardiovascular risk factors. Because of this, clinicians closely monitor heart function during treatment, using baseline and periodic imaging and managing risk factors.

Radiation therapy to the chest can also lead to cardiovascular problems, including coronary artery disease, valvular disease, or pericarditis, but these effects depend on the dose and field of radiation and tend to appear later. Immunotherapy and surgical procedures can have cardiovascular implications too, but the association with direct, dose-related cardiotoxicity is most strongly linked to chemotherapy.