It is common for chemotherapeutic agents to be associated with myocardial damage reduction in ejection fraction and heart failure.
The toxic effects of anthracyclines on the heart are well known. Doxorubicin, in a total toxic dose range of greater than 550 mg/m2, causes heart failure and arrhythmias. Daunorubicin in a total toxic dose range of greater than 550 mg/m2, has the same toxicity as doxorubicin. The anthracenedione mitoxantrone causes significant decrease in left ventricular ejection fraction and heart failure. Amsacrine at conventional doses causes ventricular arrhythmias. Cyclophosphamide at a dose of greater than 100–120 mg/kg over 2 days may cause heart failure, hem-orrhagic myocarditis, pericarditis, and necrosis of the myocardium. Ifosfamide has similar cardiotoxic effects and can cause heart failure. 5-Fluorouracil at conventional doses may cause chest pain and coronary artery spasm that causes anginal pain and rarely, myocardial infarction. Busulfan at conventional doses may cause fibrosis of the endocardium. Cisplatin at conventional doses may cause chest pain and myocardial ischemia. Vincristine and vinblastine at conventional doses may cause myocardial infarction. Mitomycin C in conventional doses causes myocardial damage that is similar to radiation-induced injury. Interferons in conventional doses may exacerbate underlying cardiac disease. Interleukin-2 in conventional doses causes abnormal heart rhythms, hypotension, and myocardial damage.