Saw cardiologist yesterday

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CypressCynthia
CypressCynthia Member Posts: 4,014 Member
edited March 2014 in Breast Cancer #1
Many of you recall that I had a mild heart attack years after my original diagnosis. In 1987 I had Stage 3A and left mastectomy, rads, chemo and tamoxifen. I have no family hx of heart disease. I have low blood pressure (rarely over 100/60), am not overweight, etc. Literally my only risk factor was having been a survivor and I knew this because I had received emails from ACS, Komen, etc.

See
Radiation for breast cancer ups heart disease risk

Breast Cancer Therapy and Heart Disease

I tell my story not to scare anyone, but to inform. If I had not been aware of my risks, I doubt that I would have chewed and aspirin and called 911. Because I took early action, I am fine. Longterm survivors need to be vigilant--especially if radiation was on the left side. Treat high cholesterol early and get out and exercise!

My cardiologist said I am doing well and wants me to have an echo just to check my valves and make sure that there is no damage. My only problem is my blood pressure stays a little low but I don't want to get off my meds (ace inhibitor, beta blocker), so I have learned to stay hydrated and manage.

Comments

  • Brooklynchele
    Brooklynchele Member Posts: 123
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    Thanks for the post
    I had declined using the recommended TAC chemo and instead went with just the TC for just the same reason. The "A" in the chemical cocktail (Adriamycin) can cause heart damage:

    Heart Risks of Doxorubicin Higher Than Previously Reported: http://www.cancer.gov/clinicaltrials/results/summary/2003/congestive-heart-failure0503

    http://lymphoma.about.com/od/livingwithlymphoma/p/cardiotoxicity.htm :
    It is well recognized that doxorubicin may cause damage to the heart in some individuals. While other anthracyclines (like epirubucun and mitoxantrone) may also cause heart damage, the chances are more common with doxorubicin. Doxorubicin causes both early and late heart damage (also called 'cardiotoxicity'). The early damage occurs immediately after drug administration or within 1 to 2 days. There are minor effects that are picked up on the electrocardiogram (EKG) and in most cases resolve without casing any major problems. It is the late-starting damage that is important and more serious.

    Late cardiac damage with doxorubicin:

    Late damage to the heart starts about a year or more after chemotherapy. Doxorubicin mainly affects the heart muscles. It weakens the heart muscles and makes the pumping of blood more difficult for the heart. When severe, it leads to a condition called congestive heart failure (CHF). Individuals with CHF complain of a number of symptoms

    * a gradually worsening difficulty in strenuous work, leading to tiredness or breathing trouble when climbing stairs or walking
    * a cough that worsens at night
    * swelling of the feet
    * difficulty in breathing at rest

    If severe, CHF can cause severe disability and even death.
  • missrenee
    missrenee Member Posts: 2,136 Member
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    Thanks for the post
    I had declined using the recommended TAC chemo and instead went with just the TC for just the same reason. The "A" in the chemical cocktail (Adriamycin) can cause heart damage:

    Heart Risks of Doxorubicin Higher Than Previously Reported: http://www.cancer.gov/clinicaltrials/results/summary/2003/congestive-heart-failure0503

    http://lymphoma.about.com/od/livingwithlymphoma/p/cardiotoxicity.htm :
    It is well recognized that doxorubicin may cause damage to the heart in some individuals. While other anthracyclines (like epirubucun and mitoxantrone) may also cause heart damage, the chances are more common with doxorubicin. Doxorubicin causes both early and late heart damage (also called 'cardiotoxicity'). The early damage occurs immediately after drug administration or within 1 to 2 days. There are minor effects that are picked up on the electrocardiogram (EKG) and in most cases resolve without casing any major problems. It is the late-starting damage that is important and more serious.

    Late cardiac damage with doxorubicin:

    Late damage to the heart starts about a year or more after chemotherapy. Doxorubicin mainly affects the heart muscles. It weakens the heart muscles and makes the pumping of blood more difficult for the heart. When severe, it leads to a condition called congestive heart failure (CHF). Individuals with CHF complain of a number of symptoms

    * a gradually worsening difficulty in strenuous work, leading to tiredness or breathing trouble when climbing stairs or walking
    * a cough that worsens at night
    * swelling of the feet
    * difficulty in breathing at rest

    If severe, CHF can cause severe disability and even death.

    Cynthia, I see a cardiologist regularly
    who is also a friend. I've had an arrhythmia for years (premature atrial contractions). I finished 6 rounds of TAC in May. I am seeing my cardiologist later this month. Would having another echocardiogram (I have them about every 2 years) show any type of damage that may have occurred? This does freak me out--my radiation was on the left side--right over my heart. They did do the IMRT radiation to minimize any internal damage, but I have to believe it still hit heart/lungs.

    Thanks for all your expert advice. I appreciate it.

    Hugs, Renee
  • Angie2U
    Angie2U Member Posts: 2,991
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    missrenee said:

    Cynthia, I see a cardiologist regularly
    who is also a friend. I've had an arrhythmia for years (premature atrial contractions). I finished 6 rounds of TAC in May. I am seeing my cardiologist later this month. Would having another echocardiogram (I have them about every 2 years) show any type of damage that may have occurred? This does freak me out--my radiation was on the left side--right over my heart. They did do the IMRT radiation to minimize any internal damage, but I have to believe it still hit heart/lungs.

    Thanks for all your expert advice. I appreciate it.

    Hugs, Renee

    Thanks Cynthia for reminding
    Thanks Cynthia for reminding us. Praying for continued good health for you.

    Hugs, Angie
  • CypressCynthia
    CypressCynthia Member Posts: 4,014 Member
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    P.S. I would not change my
    P.S. I would not change my treatment if I had it to do over. I would rather fight heart disease than the cancer beast. Just want everyone to be aware.
  • VickiSam
    VickiSam Member Posts: 9,079 Member
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    P.S. I would not change my
    P.S. I would not change my treatment if I had it to do over. I would rather fight heart disease than the cancer beast. Just want everyone to be aware.

    C.C. .. I am so worried about you, my friend ...
    and would like to 'Thank you' for all your valuable postings, love and friendship. I am so hap hap hap to hear this wonderful news! Echo's are fun, quick with mild pain when the techn is pressing against your chambers - otherwise you are in and out in 15 minutes. Only problem ... is health care coverage, or lack of it. Insurance companies don't want to pay for the $5K procedure out here in Southern California.

    Let us know when your ECHO is .. so we can all be there in the room with you. I hope I don't stepped on this time.

    Stength and Courage:

    Fellow Saints Fan .. Vicki Sam
  • Ritzy
    Ritzy Member Posts: 4,381 Member
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    VickiSam said:

    C.C. .. I am so worried about you, my friend ...
    and would like to 'Thank you' for all your valuable postings, love and friendship. I am so hap hap hap to hear this wonderful news! Echo's are fun, quick with mild pain when the techn is pressing against your chambers - otherwise you are in and out in 15 minutes. Only problem ... is health care coverage, or lack of it. Insurance companies don't want to pay for the $5K procedure out here in Southern California.

    Let us know when your ECHO is .. so we can all be there in the room with you. I hope I don't stepped on this time.

    Stength and Courage:

    Fellow Saints Fan .. Vicki Sam

    I really appreciate your
    I really appreciate your postings too Cynthia. It is always good to be informed and you are so helpful to your sisters in pink for that!

    Good news for you! And, post to let us know when you have your test as we all will be praying for you!


    Sue :)
  • CypressCynthia
    CypressCynthia Member Posts: 4,014 Member
    Options
    missrenee said:

    Cynthia, I see a cardiologist regularly
    who is also a friend. I've had an arrhythmia for years (premature atrial contractions). I finished 6 rounds of TAC in May. I am seeing my cardiologist later this month. Would having another echocardiogram (I have them about every 2 years) show any type of damage that may have occurred? This does freak me out--my radiation was on the left side--right over my heart. They did do the IMRT radiation to minimize any internal damage, but I have to believe it still hit heart/lungs.

    Thanks for all your expert advice. I appreciate it.

    Hugs, Renee

    The short answer to the echo
    The short answer to the echo question is no, although it can show some flow problems, heart enlargement and valve issues.

    There is not a single test that will tell you if you are at risk. It is imporatnt to follow cholesterol levels and probably, in my opinion, treat a little more aggressively with statins if you've had radiation, chemo, etc. See below link.

    EKG's maily show electrical activity. A stress test can be helpful in determining risks. Ultimately, the invasive angiogram is probably the only way to really visualize the vessels well, but it can have its own risks, so it is not done routinely.

    The good news is that radiation has come a long way since I had it back in 1987. The beam doesn't penetrate as far. However, study after study does put us longterm survivors at higher risk, so it is best to minimize the risks as much as possible with a healthy diet, exercise, weight control.

    Hope all of this helps!



    See:
    Breast Cancer and Cardiovascular Injury: Prevention and/or Treatment Approaches

    How to Diagnoses Coronary Artery Disease
  • CypressCynthia
    CypressCynthia Member Posts: 4,014 Member
    Options
    VickiSam said:

    C.C. .. I am so worried about you, my friend ...
    and would like to 'Thank you' for all your valuable postings, love and friendship. I am so hap hap hap to hear this wonderful news! Echo's are fun, quick with mild pain when the techn is pressing against your chambers - otherwise you are in and out in 15 minutes. Only problem ... is health care coverage, or lack of it. Insurance companies don't want to pay for the $5K procedure out here in Southern California.

    Let us know when your ECHO is .. so we can all be there in the room with you. I hope I don't stepped on this time.

    Stength and Courage:

    Fellow Saints Fan .. Vicki Sam

    Thanks Vicki Sam. And how
    Thanks Vicki Sam. And how about my Saints? They FINALLY looked like my Superbowl Champs again during the Steelers game. How is Peyton doing? I haven't watched his games, but I seem to remember that you like him too?
  • survivorbc09
    survivorbc09 Member Posts: 4,374 Member
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    Thanks Cynthia and I wish
    Thanks Cynthia and I wish you good luck with your echo.

    Hugs, Jan
  • Alexis F
    Alexis F Member Posts: 3,598
    Options

    Thanks for the post
    I had declined using the recommended TAC chemo and instead went with just the TC for just the same reason. The "A" in the chemical cocktail (Adriamycin) can cause heart damage:

    Heart Risks of Doxorubicin Higher Than Previously Reported: http://www.cancer.gov/clinicaltrials/results/summary/2003/congestive-heart-failure0503

    http://lymphoma.about.com/od/livingwithlymphoma/p/cardiotoxicity.htm :
    It is well recognized that doxorubicin may cause damage to the heart in some individuals. While other anthracyclines (like epirubucun and mitoxantrone) may also cause heart damage, the chances are more common with doxorubicin. Doxorubicin causes both early and late heart damage (also called 'cardiotoxicity'). The early damage occurs immediately after drug administration or within 1 to 2 days. There are minor effects that are picked up on the electrocardiogram (EKG) and in most cases resolve without casing any major problems. It is the late-starting damage that is important and more serious.

    Late cardiac damage with doxorubicin:

    Late damage to the heart starts about a year or more after chemotherapy. Doxorubicin mainly affects the heart muscles. It weakens the heart muscles and makes the pumping of blood more difficult for the heart. When severe, it leads to a condition called congestive heart failure (CHF). Individuals with CHF complain of a number of symptoms

    * a gradually worsening difficulty in strenuous work, leading to tiredness or breathing trouble when climbing stairs or walking
    * a cough that worsens at night
    * swelling of the feet
    * difficulty in breathing at rest

    If severe, CHF can cause severe disability and even death.

    Thanks
    You don't scare me with your posts. I find them very informative and helpful.
  • sea60
    sea60 Member Posts: 2,613
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    Thanks Cynthia!
    I've been having back pain, palpatations so it's off to have my heart checked. You're posts can save a life...thank you.

    Blessings and hugs,

    Sylvia
  • VickiSam
    VickiSam Member Posts: 9,079 Member
    Options
    sea60 said:

    Thanks Cynthia!
    I've been having back pain, palpatations so it's off to have my heart checked. You're posts can save a life...thank you.

    Blessings and hugs,

    Sylvia

    The Saints are marching on ... LOL
    Yes, they are looking like the Super Bowl Champs we know there are! I bet we see them again, this year. Peyton and the Colts are doing well! hahaha


    Mrs. Peyton Manning
  • ms.sunshine
    ms.sunshine Member Posts: 707 Member
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    VickiSam said:

    The Saints are marching on ... LOL
    Yes, they are looking like the Super Bowl Champs we know there are! I bet we see them again, this year. Peyton and the Colts are doing well! hahaha


    Mrs. Peyton Manning

    Thanks for the valued info
    I'm seeing my dr. next week and was wondering if I should request a heart test. I will now that I have read your post.