Cardio-Oncology: What It Is, Who It’s For and How It Can Help

Jennifer Shea, MD, FACC, is a cardiologist at Virginia Heart’s Vienna office. She is Co-Founder of Inova Heart and Vascular Institute’s (IHVI) Cardio-Oncology Program. 

Undergoing cancer treatment is a journey that demands your attention and focus. Many people will stop at nothing to eradicate the tumor and make the triumphant transition from “cancer patient” to “cancer survivor.” However, for people undergoing certain kinds of cancer treatment or who have existing heart problems, it’s important to keep long-term heart health in mind as well. At IHVI’s Cardio-Oncology Program, we help people win their battles with cancer, while also protecting their hearts in the process.

What is cardio-oncology?

Broadly, cardio-oncology focuses on the cardiovascular management of patients with cancer – including prevention, diagnosis and treatment of heart disease. In 2019, IHVI launched its cardio-oncology clinic, embedded within our ambulatory cardiology practices.

Many of our current patients are breast cancer patients, since some of the more common chemotherapy drugs for certain types of tumors can be damaging to the heart. However, any person who currently has cancer, or who has a history of cancer, can potentially benefit from a consultation with a cardio-oncologist. In our program, we’re currently expanding to serve people with gynecologic and gastrointestinal cancers, as well as leukemia and lymphoma.

Who does it help?

Most often, cardio-oncology comes into play when chemotherapy is part of the treatment plan. Inova Schar Cancer Institute’s oncologists use a screening tool to find out whether individuals are at low risk or higher risk of damaging their heart during cancer treatment – a complication known as cardiotoxicity. People who are at high risk will be referred to a cardio-oncologist for a consultation before chemotherapy begins. Other community-based oncologists also refer at-risk patients to the program.

Factors that affect an individual’s risk of cardiotoxicity from cancer treatment include:

  • The kind of chemotherapy drug the individual will be getting
  • The person’s age
  • A history of previous chemotherapy or radiation to the chest
  • The individual’s cardiac history
  • Risk factors for heart disease such as high blood pressure, obesity, smoking, diabetes and high cholesterol

At the initial consultation, high-risk patients will receive a thorough, comprehensive evaluation of their cardiac health in the setting of a cancer diagnosis. The cardio-oncologist and the patient will review the entire oncology plan, give clearance for surgery, if needed, and discuss potential cardiac risks of chemotherapy and radiation. The patient will also receive a risk factor screening and treatment for cardiac risk factors such as high blood pressure or high cholesterol.

Even patients who are found to be at low risk of cardiotoxicity will be monitored carefully if they are receiving a class of chemotherapy drug that has been known to cause heart damage in some cases. All patients receiving these chemotherapy regimens are screened with a baseline echocardiogram before starting chemotherapy, to help the cancer team identify problems with the heart’s function right away. Throughout the course of chemotherapy, the patient will have periodic follow-up echocardiograms. That way, if any problems begin to develop, the team knows about it right away and can refer the patient to the cardio-oncology program for specialized care.

If a patient does develop cardiotoxicity, the cardio-oncologist manages it with medication. During chemotherapy, there can also be subtle changes to the heart. Using newer echocardiographic techniques, these changes can be identified earlier and cardioprotective medications started before toxicity fully develops. These medications remain for the duration of the chemotherapy treatment.

How IHVI’s cardio-oncology program helps people with cancer

The cardio-oncology program’s goal is to make sure that a patient who has cancer today does not become a cardiology patient tomorrow. Our expertise is geared toward protecting patients’ hearts while completing all of the chemotherapy that their oncologist has recommended.

We take a team-based approach to our work, collaborating closely with the patient’s oncologist. The oncologist defines the treatment strategy and goal of treatment, and the cardio-oncologist, with specialized expertise in the interaction between cancer treatment and heart health, helps to modify the chemotherapy drugs’ risks to people who are at higher risk of damaging their heart during treatment.

Throughout treatment, the cardio-oncologist and the oncologist will engage in ongoing discussions about the best course of treatment for a specific individual’s cancer. We communicate and collaborate regularly with our oncology colleagues, and the cardio-oncology team meets regularly as well, to ensure we are using the most up-to-date, evidence-based treatment protocols available.

Patients can be referred to our program by their oncologist or their primary care doctor, and patients can also call our program directly to schedule an appointment.

To make an appointment, call 571-472-2972. Learn more about IHVI’s Cardio-Oncology Program.


  1. Edna on February 28, 2022 at 10:57 pm

    Important infomation everyone should be aware of’.

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