When cancer and heart disease are combined, managing both conditions can be challenging for both patients and doctors. Many therapies used to treat patients with cancer can increase the risk of cardiac complications. Since heart disease and risk factors for heart disease (high blood pressure, diabetes, elevated cholesterol, smoking and obesity) are common conditions for patients with cancer, collaborative care between a cardiologist and an oncologist is needed to prevent and manage cardiovascular complications which may arise during treatment. Even some cancer patients without a pre-existing heart problem may develop a cardiac complication as a result of chemotherapy and radiation. This novel new discipline between cardiology and oncology is referred to as “Cardio-Oncology.” The UofL Physicians Cardio-Oncology team works to maximize the use of lifesaving chemotherapy and minimize any delays in cancer treatment plans to optimize the care for each individual patient.
Due to the major advancements in cancer treatments in the last two decades there is a tremendous growth in the number of cancer survivors who have a unique set of challenging medical issues that must be addressed. It is estimated that by year 2020, there will be roughly 18 million cancer survivors in the United States, one of the largest growing population of individuals who will be accessing the health care system. Heart disease in cancer survivors is one of the leading causes of death behind recurrent cancer, and thus Cardio-Oncology programs are well suited to help cancer survivors assess cardiac risk factors, prevent future cardiac problems and ultimately improve overall quality of life.
UofL Physicians – Cardio-Oncology program is the result of close collaboration between UofL Physicians – Cardiovascular Medicine, the University of Louisville School of Medicine and the James Graham Brown Cancer Center. It is the only program of its kind in Kentucky.
The program is led by a team of cardiologists, oncologists and researchers who specialize in the coordinated care of oncology patients and survivors with cardiovascular disease and cardiac risk factors. One of the main goals of the program is to identify patients with cancer who may be at an increased risk for chemotherapy-induced heart problems.
Risk factors for chemotherapy-related complications can include:
- High blood pressure
- Elevated cholesterol
- Smoking history
- Metabolic syndrome
- Heart rhythm abnormalities
- Coronary artery disease/heart attack
- Heart valve complications
- Family history of heart disease
UofL Physicians – Cardio-Oncology program provides comprehensive care focused on prevention and maintenance of cardiovascular disease with incorporation of healthy lifestyle factors. UofL Physicians – Cardio-Oncology program works closely with survivorship programs and cancer rehabilitation specialists to return survivors to a high quality of life.
Diseases & Conditions
Heart disease is the most common cause of death in the U.S. Some heart disease can be a side effect of chemotherapy. Now that doctors are more fully aware of this side effect, physicians are performing thorough risk assessments and cardiac screening to prevent and treat any cardiac complication that may arise from chemotherapy treatment. There is a growing need for some cancer patients and survivors to see a heart specialist. UofL Physicians – Cardio-Oncology program helps to identify high-risk patients and works to minimize potential damage to the heart.
UofL Physicians – Cardio-Oncology program sees patients with a history of abnormal heart conditions (systolic/diastolic heart failure, coronary artery disease/heart attack, heart rhythm abnormalities, heart valve complication) who will undergo surgical treatment, radiation or chemotherapy for cancer. In addition, the Cardio-Oncology program helps to evaluate and treat patients with risk factors for cardiovascular disease including: high blood pressure, elevated cholesterol, metabolic syndrome and family history of heart disease, prior to and during cancer treatment.
Treatments & Services
Through innovative techniques such as echocardiography, strain echocardiography, cardiac MRI, angiography, nuclear imaging and cardiac biomarkers we identify high risk patients and work to minimize potential heart damage.
We tailor each treatment to the individual patient, based on the aggressiveness of cancer and overall prognosis, with a goal of minimizing cardiac problems from cancer-related therapies by addressing each individual’s risk factors.
Through the use of cardio-protective medications and close monitoring, patients can keep receiving necessary chemotherapeutic agents while minimizing their risk for developing heart disease.
Echocardiography, also called an echo test or heart ultrasound, is a test that takes “moving pictures” of the heart with sound waves. An echo uses sound waves to create pictures of your heart’s chambers, valves, walls and the blood vessels (aorta, arteries, veins) attached to your heart. A probe called a transducer is passed over your chest. The probe produces sound waves that bounce off your heart and “echo” back to the probe. These waves are changed into pictures viewed on a video monitor. The echo test also measures your ejection fraction, which is the amount of blood pumped out of the heart during each heartbeat (contraction). It’s usually expressed as a percentage.
Strain echocardiography analyzes the motion of tissues in the heart using sound waves to determine if there is an abnormal patter of heart contraction that suggest early signs of cardiotoxicity. Strain echocardiography is usually performed during a routine echocardiogram to help aid in the detection of early signs of heart damage.
Cardiac MRI creates both still and moving pictures of your heart and major blood vessels. We use cardiac MRI to get pictures of the beating heart and to look at its structure and function. These pictures can help decide the best form of treatment. It is used to diagnose and assess many diseases and conditions, including:
- Coronary heart disease
- Damage caused by a heart attack
- Heart failure
- Heart valve problems
- Congenital heart defects
- Cardiac tumors
Angiography is a medical imaging technique used to visualize the inside of blood vessels and organs of the body, with particular interest in the arteries, veins and heart chambers.
Nuclear imaging checks the blood flow to the heart muscle. If part of the muscle isn’t getting blood, it may be a sign of coronary heart disease, which can lead to chest pain, heart attack and other heart problems. For this test, a safe, radioactive substance called a tracer is injected into your bloodstream through a vein. The tracer travels to your heart and releases energy. Special cameras outside your body detect the energy and use it to create pictures of your heart and the blood flow to the heart muscle.
Nuclear Multi-Gated Acquisition Scan
A MUGA (multiple-gated acquisition) scan or radionuclide ventriculography (RVG) is a type of nuclear imaging test that shows how well your heart is pumping. A MUGA scan is a test using a radioactive tracer (called a radionuclide) and a special camera to take pictures of your heart as it pumps blood. The test measures your ejection fraction, which is the amount of blood pumped out of the heart during each heartbeat (contraction). It’s usually expressed as a percentage
Cardiac biomarkers evaluate heart function. By measuring these markers, we are taking a step toward diagnosing a possible heart condition. These markers tell us whether or not more tests are necessary for those who may be at a lower risk for heart problems.
Shahab Ghafghazi, M.D.
Areas of Interest: Preventive Cardiology | Cardio-Oncology | Echocardiography
Primary Practice LocationUofL Physicians – Cardiology Associates
UofL Health - Chestnut Street Outpatient Center
401 East Chestnut Street, Suite 310
Louisville, KY 40202
UofL Physicians participates in most major health plans in Kentucky. Coverage may vary by specialty. Coverage limitations are dependent on the terms of your personal health plan. This is not a guarantee that all services you receive will be covered by your health plan. Review your health plan provider directory and/or consult with your plan to confirm coverage.