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Iatrogenic heart failure 

Iatrogenic heart failure

Martin Denvir


Heart failure (HF) can result from adverse or unwanted effects oftreatment for unrelated conditions. Iatrogenic literally means anillness or condition generated by the physician (from the Greekiatros, a physician, and genic meaning ‘induced by’). In the acutesetting, the physician can induce HF — in a patient without anyclinically overt cardiac disease — by the inadvertent use of high volumes of fluid, or drugs known to depress cardiac function; or duringcardiac surgery when the left ventricle experiences injury (eitherdirectly or indirectly) while on cardiopulmonary bypass. ChronicHF, on the other hand, is more common in patients treated forlymphoma, breast cancer, or more rarely lung cancer. In this clinicalsetting, the patient may present many months or years after theinitial injury to the heart resulting from chemotherapeutic agentsand/or radiotherapy. This chapter outlines the main causes of HFinduced by the physician in the acute setting, and focuses on theepidemiology, presentation, and treatment of chronic HF syndromesresulting from treatment of childhood and adult cancers.

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