Emergence, development, and future of cardio-oncology in China: cardiohypersensitivity, cardiotoxicity and the Kounis syndrome

[...]chemotherapy can induce cardiovascular worsening, manifesting as acute and chronic symptomatology. [...]the very interesting report published in Chinese Medical Journal[2] concerning a 60-year-old male patient suffering from coronary artery disease and squamous cell carcinoma of the left lung who developed an ST segment elevation myocardial infarction following treatment with afatinib (tyrosine kinase inhibitor) and gemcitabine (antimetabolite pyrimidine antagonist) and cisplatin (platinum based DNA replication inhibitor) and the subsequent discussion raise several important considerations on cardiac toxicity, cardiac hypersensitivity and the Kounis-hypersensitivity acute coronary syndrome. Definition of cardiotoxicity and cardiohypersensitivity[3]: As far as cardiotoxicity is concerned, this term lacks consensus across the medical societies, especially when this term is used to characterize the acute adverse effects of chemotherapeutic agents and is referred to as heart damage or toxicity of the heart,[4] cardiac dysfunction[5] and septal cardiomyopathy, heart failure with audible third heart sound, gallop rhythm, tachycardia, or diminished left ventricular ejection fraction. The need for specialized cardiovascular clinics for treating cancer patients in order to provide expert pre-therapy assessment, monitoring and treatment that facilitates and does not delay cancer therapy is of high importance. [...]as has been steadily gaining attention in China,[2] the interdisciplinary cooperation among cardiologists, oncologists, hematologists, cardiac imaging specialists, immunologists, pathologists, allergists together with other medical professionals associated with cancer care seems to be mandatory.