Cardiac complications associated with HSCT

This chapter focuses on cardiotoxicity that may occur during the perior early post-HSCT period. The long-term cardiac sequelae associated with HSCT are addressed in Chap. 26. Cardiac complications may be related to the toxic effects of the conditioning regimen, radiation, prior exposure to cardiotoxic agents, infections, and graft-versus-host disease (GvHD). HSCT-associated cardiac complications include heart failure, arrhythmias, pericarditis, myocarditis, endocarditis, pericardial effusion, and cardiac tamponade. Cardiac complications may occur acutely during the peri-HSCT period (as defined as the time during conditioning through engraftment) or may be delayed by weeks to years. With the exception of sinus tachycardia, cardiac complications are rare during the peri-HSCT period. However, when they do occur, they are usually life-threatening because heart failure, cardiac tamponade, and dysrhythmias are the most common early cardiac complications. More frequently, the manifestations of the cardiac damage acquired during the peri-HSCT period may be delayed for years, requiring lifelong cardiac monitoring (at least annually with ECHO and ECG) for all post-HSCT patients who are at risk.