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Hola! La verdad me parece que lograron incluir muchisima información relevante. Me preocupa que las drogas legales sean parte de los agentes causantes de de mayores afectaciones cardiovasculares, en especial en Costa Rica que para toda celebración se consume licor.
Asi mismo la obesidad, ya que estamos copiando patrones de los estadounidenses, por suerte en Costa Rica nos mueven las modas y este 2020 con la pandemia la gente esta haciendo ejercicio.

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El sistema cardiovascular está formado por:
- El corazón
- Los vasos sanguíneos:
arterias, venas y capilares.

Se trata de
un sistema de transporte en
el que una bomba muscular (el corazón) proporciona
la energía necesaria para mover el contenido (la sangre), en
un circuito cerrado de tubos elásticos (los vasos).

(Agregado por
Katerina Vargas)

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Association of body mass index and cardiotoxicity related to anthracyclines and trastuzumab in early breast cancer: French CANTO cohort study

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Association of body mass index and cardiotoxicity related to anthracyclines and trastuzumab in early breast cancer: French CANTO cohort study

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https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1002989

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Ejemplos de agentes tóxicos que afectan el Sistema Cardiovascular

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Ejemplos de agentes tóxicos que afectan el Sistema Cardiovascular

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En la actualidad las causas más frecuentes de cardiotoxicidad son el tabaco, el alcohol y algunas drogas de abuso como la cocaína y los estimulantes tipo anfetaminas, pero existen numerosos tóxicos orgánicos e inorgánicos que pueden producir alteraciones miocárdicas funcionales o estructurales (Calabuig, 2018).
Referencia:
https://books.google.co.cr/books?id=MfVyDwAAQBAJ&pg=PA851&dq=ejemplos+de+agentes+t%C3%B3xicos+que+afectan+el+sistema+cardiovascular&hl=es&sa=X&ved=2ahUKEwjVqp2VqMPsAhWR1FkKHaSSAGUQ6AEwBnoECAgQAg#v=onepage&q=ejemplos%20de%20agentes%20t%C3%B3xicos%20que%20afectan%20el%20sistema%20cardiovascular&f=false

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La obesidad es un factor de riesgo de cardiotoxicidad en pacientes con cáncer de mama tratados con quimioterapia

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La obesidad es un factor de riesgo de cardiotoxicidad en pacientes con cáncer de mama tratados con quimioterapia

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https://www.infosalus.com/farmacia/noticia-obesidad-factor-riesgo-cardiotoxicidad-pacientes-cancer-mama-tratados-quimioterapia-20191226071143.html

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Exposure to Agrochemicals and Cardiovascular Disease: A Review

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Exposure to Agrochemicals and Cardiovascular Disease: A Review

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https://www.researchgate.net/publication/295082198_Exposure_to_Agrochemicals_and_Cardiovascular_Disease_A_Review

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Toxicidad cardiovascular por parches transdérmicos de rivastigmina.  MARIANELA 

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Toxicidad cardiovascular por parches transdérmicos de rivastigmina.  MARIANELA 

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https://www.redalyc.org/jatsRepo/4797/479761371015/html/index.html

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La cardiotoxicidad​ es una alteración cuantitativa o cualitativa en el corazón debido a los fármacos u otras sustancias tóxicas para este órgano. Puede evolucionar a insuficiencia cardiaca o arritmias.

Tipos
Existen diferentes tipos de cardiotoxicidad:

Cardiotoxicidad aguda: Durante el tratamiento. Se manifiesta con taquicardias supraventriculares. Desaparece al interrumpir el tratamiento.

Cardiotoxicidad crónica: Hasta 30 meses después de la última dosis. A los tres meses desarrolla miocardipatía degenerativa que culmina en insuficiencia cardiaca congestiva (ICC). Dentro de esta existe una subcategoria que es la cardiotoxicidad tardía que aparece de 6 a 12 años después del tratamiento. Se manifiesta como una recaída en recuperados de una cadiotoxicidad aguda.

Mecanismos de producción

Interferencia de homeostasis ionica

Inhibición de la ATPasa Na+ - K+

Alteraciones del riego coronario

Estres oxidativo

Alteraciones de las organelas

Apoptosis

Cuando un estímulo llega al corazón se produce una entrada de cationes de Na+ y una salida de K+.Todo esto es controlado por la Bomba de Sodio. Pero esto no se produciría sin la intervención de las enzimas Na+-ATPasa para la entrada de Na+, y la K+-ATPasa para la salida de K+.

Pero también cuando el estímulo alcanza la fibra muscular, penetran por unos poros Ca2+ que gracias al ATP permite el deslizamiento de la actina sobre la miosina y así producirse la contracción muscular. Los fármacos actúan aumentando la cantidad de iones de Ca2+ libres en el interior de la célula miocárdica, con lo que se incrementa la excitación de la membrana y el rendimiento muscular. Cuando hay una sobrecarga de Ca2+, se produce un trastorno y el producto actúa como cardiotóxico.

Todos estos mecanismos fisiológicos pueden ser alterados por numerosas sustancias químicas originándo:

Trastornos del ritmo o disritmias.
Insuficiencia cardiaca
Miocarditis tóxica.
Toxinas producidas por organismos

Son numerosos péptidos naturales endógenos y exógenos son cardiotóxicos. Por un lado hay péptidos de carácter hormonal que ejercen sobre los mamíferos actividad cardiodepresora y vasocontrictora, y por otro lado, las toxinas que son segregadas por las plantas y los animales
-Celentéreos
-Moluscos
-Artrópodos
-Serpientes

Fármacos
-antiarrítmicos
-procinéticos
-antihistamínicos.
-antimicrobianos
-catecolaminas
simpaticomiméticas
-antraciclinas
-antidepresivos tricíclicos. Hormonas
esteroides, estrógenos, progestinas, andrógenos y hormonas tiroideas.

Productos industriales
Alcohol: Una intoxicación aguda por este tóxico produce retraso de la conducción y descenso del umbral para entrar en fibrilación ventricular (excitación repetida y rápida de los ventrículos). El consumo prolongado de etanol se asocia a alteraciones miocárdicas, arritmias y un proceso conocido como miocardiopatía alcohólica.

Disolventes: que actúan a través del sistema nervioso, que es el responsable de regular la actividad eléctrica del corazón.
Alcanos halogenados: Sus propiedades intensamente lipófilas les permiten atravesar fácilmente la barrera hematoencefálica, donde producen depresión en el Sistema Nervioso Central (SNC).
Metales pesados: Estos tienen efectos tóxicos inotrópicos y cronotrópicos negativos y también pueden producir hipertrofia cardíaca.

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Según Gisbert Calabuig, en el caso del miocardio, el daño tóxico compromete el sistema metabólico de un tejido que requiere gran cantidad de energía para funcionar. Puede producirse pro efecto directo, que es dependiente de la dosis y del tiempo, por mecanismos farmacológicos, como ocurre con la prolongación del tiempo QT que producen los antidepresivos tricíclicos, los neurolépticos o algunos antibióticos o por reacciones de hipersensibilidad. La acción tóxica puede afectar a la función cardíaca por alterar el equilibrio iónico, la función contráctil y/o los sistemas de producción de energía.
La respuesta miocárdica es variada, afecta tanto al miocardio como al sistema de conducción, las válvulas, el endocardio y/o el pericardio, e incluye degeneración, hipertrofia, apoptosis y necrosis de los miocardiocitos.
Sin embargo, muchos xenobióticos que inducen arritmias o interfieren en la acción metabólica suelen causar la muerte sin llegar a producir alteraciones morfológicas.

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Agentes ambientales de origen natural y antrópico tienen el potencial de causar cardiotoxicidad y potenciar el fallo cardiaco. Entre ellas es posible encontrar:
-Material particulado.
-Toxinas animales y vegetales (veneno de serpientes, arañas o escorpiones; cocaína y cafeína).
-Sustancias químicas como el cadmio, plomo, cobalto, manganeso, níquel y arsénico.
-Pesticidas.

Fuente consultada:

Bidulescu, A., Stein-Alexandrescu, A. D., & Horbal, S. R. (2019). Cardiotoxicity. Encyclopedia of Environmental Health, October, 535–542. https://doi.org/10.1016/B978-0-12-409548-9.11716-6

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What is cardiac toxicity (or cardiotoxicity)?

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What is cardiac toxicity (or cardiotoxicity)?

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Cardiac toxicity is damage to the heart by harmful chemicals. As part of your treatment, you may be given toxins (drugs) to kill cancer cells. A side effect is that the normal cells in and around your heart can also be killed. Besides cell death, other types of cardiac toxicity from cancer treatment include:

Cardiomyopathy is when heart muscle becomes weakened, enlarged, thickened, or stiff. This can lead to changes in heart rhythm or to heart failure.
Myocarditis is inflammation (swelling) of the heart. This can lead to changes in heart rhythm or heart failure.
Pericarditis is inflammation (swelling) of the sac surrounding the heart. This can cause chest pain or heart failure.
Acute coronary syndromes are caused by blood vessel damage, which reduces blood flow to the heart. This can cause chest pain or a heart attack (myocardial infarction).
Congestive heart failure is when the heart is unable to pump enough blood throughout the body. Chemotherapy can cause mild or severe damage to the heart. If severe, congestive heart failure or other life-threatening problems can occur. A heart transplant may even be needed.

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What is cardiac toxicity (or cardiotoxicity)?

Cardiac toxicity is damage to the heart by harmful chemicals. As part of your treatment, you may be given toxins (drugs) to kill cancer cells. A side effect is that the normal cells in and around your heart can also be killed. Besides cell death, other types of cardiac toxicity from cancer treatment include:

Cardiomyopathy is when heart muscle becomes weakened, enlarged, thickened, or stiff. This can lead to changes in heart rhythm or to heart failure.

Myocarditis is inflammation (swelling) of the heart. This can lead to changes in heart rhythm or heart failure.

Pericarditis is inflammation (swelling) of the sac surrounding the heart. This can cause chest pain or heart failure.

Acute coronary syndromes are caused by blood vessel damage, which reduces blood flow to the heart. This can cause chest pain or a heart attack (myocardial infarction).

Congestive heart failure is when the heart is unable to pump enough blood throughout the body. Chemotherapy can cause mild or severe damage to the heart. If severe, congestive heart failure or other life-threatening problems can occur. A heart transplant may even be needed.

What cancer treatments cause cardiac toxicity?

Chemotherapy

The chemotherapy drugs that most commonly cause heart damage are anthracyclines. Anthracyclines are used to treat many types of cancers. Examples include some types of leukemia, lymphoma, sarcomas as well as bladder, bone, breast, head and neck, kidney, skin, stomach, and other cancers. Anthracyclines include:

Daunorubicin (Cerubidine®),

Doxorubicin,

Doxorubicin liposome injection (Doxil®),

Epirubicin (Ellence®),

Idarubicin (Idamycin® PFS), and

Valrubicin (Valstar®)

In rare cases, cyclophosphamide can damage the heart. This chemotherapy drug is an alkylating agent. It is sometimes used to treat some types of leukemia, lymphoma, myeloma, and sarcomas as well as bone, breast, central nervous system, ovarian, and skin cancers.

Targeted therapy

Targeted therapy drugs that can cause damage to the heart include trastuzumab (Herceptin ®), bevacizumab (Avastin ®), lapatinib (Tykerb ®), sunitinib (Sutent ®), and sorafenib (Nexavar ®). These drugs are used in a variety of cancer types.

Radiation therapy

Many patients with cancer get radiation therapy to the chest. Examples of cancers that may be treated with radiation include breast cancer, lung cancer, lymphoma, and some childhood cancers. This radiation can damage the blood vessels that bring blood to the heart. Patients who are treated with both anthracyclines and radiation to the chest are at high risk for heart problems. So are patients who are treated with both anthracyclines and trastuzumab.

Who is at increased risk for cardiac toxicity?
Patients who are older, young children, and women have a greater risk for cardiac toxicity. In addition, patients who have other health conditions at the same time as cancer are at increased risk. This is especially true for patients with signs of heart trouble before cancer.

What are the symptoms of cardiac toxicity?
You may not notice any symptoms. Then again, you might have chest pain or notice changes in your heart rhythm. Arrhythmias are health problems with the speed or rhythm of the heartbeat. Atrial fibrillation is the most common type of arrhythmia. It is an abnormal beating of the heart's upper left chamber. It is common not to notice atrial fibrillation.

Your doctor may tell you that you have a decline in LVEF ( left ventricular ejection f raction). This means your heart isn't pumping as much blood with each heartbeat as it should. Your treatment will likely be changed if this happens, and you may be started on drugs to help your heart.

If the damage is severe, you may have congestive heart failure. You will probably feel very tired and have trouble breathing. You will first notice the shortness of breath when you are active. Later, you will be short of breath even while resting. Congestive heart failure causes you to gain weight and your ankles to swell. You may also find it uncomfortable to lie on your back.

You might not notice these symptoms until many months or even years after you have completed cancer treatment. Tell your doctor if you any of these symptoms start.

How is cardiac toxicity diagnosed?
Your heart will likely be checked before you start treatment. This will tell your doctor about your baseline (pre-treatment) heart health. Your heart will also be checked regularly during treatment, when starting different treatments, and after you are done with treatment. These are some common tests used to check your heart:

Physical exam is a review of your body for signs of disease. During this exam, your doctor may listen to your heart with a stethoscope. If it does not sound normal, there may be damage to your heart.

Chest X-ray is a type of imaging test that makes pictures of the insides of your chest. Your doctor can see if your heart looks too big or if fluid is building up in your lungs.

Echocardiogram is a type of imaging test that uses ultrasound. Ultrasound bounces sound waves off of organs to make pictures. Your doctor may use an echocardiogram to see your heart in action. Your doctor will be able to see if your heart is pumping enough blood. This is the test used to measure LVEF.

ECG (electrocardiogram) is a test that measures the electrical activity of the heart. It lets your doctor see your heart rhythm in detail.

MUGA (multi-gated acquisition) scan is a test that injects a radiotracer into your vein. The radiotracer attaches to red blood cells. Next, a special camera is used to see the radiotracer go through your heart. Your doctor can then see how well your heart is pumping. Your doctor can also see how well the blood vessels to the heart are working.

Troponin blood tests are done less often. Troponins are proteins found in heart muscle. Troponins are released by dying heart cells and then enter the bloodstream. Troponins may be in your blood even before a decline in LVEF is seen. The use of troponins in the blood to predict heart problems is still being studied.

How can cardiac toxicity be prevented?
Cardiac toxicity can often be prevented by giving less of the cancer drug. Also, you could get lower doses more often instead of larger doses less often. There may be drugs that are less toxic. For example, doxorubicin liposome injection, a liposomal anthracycline, is less toxic than regular doxorubicin.

The problem is balance. You don't want to have more treatment than is needed to treat the disease. Then again, you don't want to undertreat the cancer just to lower the chance of side effects. You should talk to your doctor about the balance of risks and benefits of cardiotoxic treatment for you.

For breast cancer, sometimes dexrazoxane (Zinecard ®) is used to prevent or lessen heart damage caused by doxorubicin or epirubicin. It is given right before either drug to protect your heart.

Other drugs are now being tested for prevention of damage to the heart in high-risk patients. These include enalapril, an ACE ( angiotensin- converting e nzyme) inhibitor, and carvedilol, a beta-blocker.

How is cardiac toxicity treated?
If treatment for cardiac toxicity is started early, it is more likely that serious heart damage will be prevented. If you have heart failure because of cancer treatment, you will be treated like other patients with heart failure. You may be given some combination of these medicines:

A diuretic (to control your fluids),

An ACE inhibitor (to control your blood pressure),

A beta-blocker (to control your blood pressure), or

A digitalis drug (to make your heart stronger and to regulate heart rhythm).

In severe cases, a heart transplant may be needed.

Questions for your doctor

Do the treatments you are suggesting cause cardiac toxicity?

What type of heart damage may occur?

Are there safer treatments or treatment schedules we can use?

Would these safer choices affect how well my cancer is treated?

Is dexrazoxane right for me?

How and how often will my heart be checked for problems?

Are there any clinical trials that I can join?

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Cardiac toxicity is damage to the heart by toxins. It can also be called cardiotoxicity. During chemotherapy, you are given toxins (drugs) to kill cancer cells. A side-effect is that the normal cells in and around your heart can also be killed.

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El corazón debe contemplarse como un órgano con características de conducción eléctrica intrínseca, susceptible por tanto a variaciones y efectos en dicho sistema
Ciertos cardiotóxicos pueden repercutir en su funcionalidad de forma directa e indirecta,
Algunos dentro de los cuales característicamente se encuentran los antiaritmicos, alcohol ,disolventes y metales pesados.