What CARDIAC signs and symptoms should I watch for in patients on Herceptin?
• A: Herceptin can cause left ventricular cardiac dysfunction, arrhythmias, hypertension, disabling cardiac failure, cardiomyopathy, and cardiac death. Herceptin can also cause asymptomatic decline in LVEF. In the BCIRG study, there was a higher incidence of cardiac ischemia/infarction in the Herceptin-containing regimens (TCH [0.2%] and AC→TH [0.3%]) as compared to the non-Herceptin-containing regimen (AC→T [0.0%]) (Herceptin PI, May 2008). Manifestations associated with heart failure are dyspnea (shortness of breath not related to exercise or exertion), fatigue, and fluid retention. Other signs and symptoms that suggest heart failure include irregular heartbeat (tachycardia, S3 gallop), jugular vein distention, peripheral edema, sudden weight gain, swelling or pain in the abdomen, decreased exercise tolerance, trouble sleeping, frequent dry, hacking cough or wheezing, loss of appetite, confusion/decreased alertness, chest pain/palpitations, fainting/lightheadedness, and low amounts o
