. 2021 Apr 15;11(4):1132–1147.

Table 1.

List of chemotherapy agents which cause cardiotoxicity

Serial No	Agent	Cardiotoxic Effect	Management	Ref
Anthracyclines and Antitumor Antibiotics
1.	Doxorubicin	LV dysfunction/HF/Arrhythmias	• General-Dexrazoxane	[4,10,19,21,30]
			• LV dysfunction-D/C agent, ACEI, and β-blocker
			• HF-D/C agent, ACEI (enalapril), and β-blocker (Carvedilol)
			• Arrhythmias-antiarrhythmics
2.	Daunorubicin	LV dysfunction/HF/Arrhythmias	• General-Dexrazoxane	[4,10,19,21,30]
			• LV dysfunction-D/C agent, ACEI, and β-blocker
			• HF-D/C agent, ACEI (enalapril), and β-blocker (Carvedilol)
			• Arrhythmias-antiarrhythmics
3.	Mitoxantrone	LV dysfunction/HF/Arrhythmias	• General-Dexrazoxane	[4,10,19,21,30]
			• LV dysfunction-D/C agent, ACEI, and β-blocker
			• HF-D/C agent, ACEI (enalapril), and β-blocker (Carvedilol)
			• Arrhythmias-antiarrhythmics
4.	Epirubicin	LV dysfunction/HF/Arrhythmias	• General-Dexrazoxane	[4,10,19,21,30]
			• LV dysfunction-D/C agent, ACEI, and β-blocker
			• HF-D/C agent, ACEI (enalapril), and β-blocker (Carvedilol)
			• Arrhythmias-antiarrhythmics
5.	Mitoxantrone	Arrhythmia/HF	• Arrhythmias-antiarrhythmics	[25]
5.	Mitoxantrone	Arrhythmia/HF	• HF-D/C agent, ACEI, and β-blocker	[25]
6.	Bleomycin	Pericarditis/CAD/Atherosclerosis	• Pericarditis-NSAIDs, colchicine; prednisone if severe	[25,54]
			• CAD-statin, ADP receptor inhibitor, nitrate, β-blocker
			• Atherosclerosis-statins
7.	Mitomycin C	HF	• HF-D/C agent, ACEI, and β-blocker	[25]
Alkylating agents
1.	Cyclophosphamide	Cardiac Tamponade/Arrhythmias/HF	• Cardiac Tamponade-pericardiocentesis, dobutamine	[10,25,27]
			• Arrhythmias-antiarrhythmics
			• HF-D/C agent, ACEI, and β-blocker
2.	Ifosfamide	Similar to Cyclophosphamide		[10,25]
3.	Bleomycin	Myocardial Ischemia	• Myocardial ischemia-anticoagulation, aspirin, ADP receptor inhibitor	[10,56]
4.	Melphalan	Acute cardiomyopathy	• Acute cardiomyopathy-D/C agent, ACEI, β-blocker, cardiac glycoside	[43]
Platinum based agents
1.	Cisplatin	HTN/CAD/Thromboembolic Events/Angina/HF/Arrythmias	• HTN-ACEI and Ca²⁺ channel blocker (CCB)	[2,10,25,54,56]
			• CAD-statin, ADP receptor inhibitor, nitrate, β-blocker
			• Thromboembolic Events-LMWH, edoxaban, or rivaroxaban
			• HF-D/C agent, ACEI, and β-blocker
			• Angina-aspirin, ADP receptor inhibitor, nitrate, β-blocker
			• Arrythmias-antiarrhythmics
Antimetabolites
1.	5-fluorouracil	Angina/MI/Arrhythmias/Cardiomyopathy/HF	• General-D/C agent	[2,25,30,31,35]
			• Angina-aspirin, ADP receptor inhibitor, nitrate, β-blocker
			• MI-PCI or IV thrombolytics as per AHA guidelines
			• Arrhythmia-if acute and pt unstable: cardioversion or defibrillation; Long term treatment with antiarrhythmics
			• Cardiomyopathy-aspirin, statin, β-blocker
			• HF-ACEI and β-blocker
2.	Capecitabine	Similar to 5-FU		[2,25,31]
Antimicrotubular Agents
1.	Paclitaxel	Arrhythmia/Heart Block/HF/HTN	• Arrhythmias-antiarrhythmics	[2,10,30,54]
			• Heart Block-monitoring; potential pacemaker placement
			• HF-D/C agent, ACEI, and β-blocker
			• HTN-ACEI and CCB
2.	Docetaxel	Arrhythmia/Heart Block/HF	• Arrhythmias-antiarrhythmics	[2,10,25,30]
			• Heart Block-monitoring; potential pacemaker placement
			• HF-D/C agent, ACEI, and β-blocker
3.	Vinblastine	Angina/MI	• Angina-aspirin, ADP receptor inhibitor, nitrate, β-blocker	[10,56]
3.	Vinblastine	Angina/MI	• MI-PCI or IV thrombolytics as per AHA guidelines	[10,56]