In the United States, the lifetime risk of a cancer diagnosis is nearly 40%; in 2016, that represents almost 1.6 million new patients, and despite advances in early diagnosis and treatment, roughly 35% will ultimately die of their malignancy. Fortunately, the number of patients living with a cancer diagnosis also continues to expand, anticipated to be more than 19 million in less than a decade. In calculating the relative risks and benefits of therapy, it is therefore important to consider the morbidity and mortality associated with antitumor therapy itself. Significantly, excluding demise due to the malignancy itself, treatment-induced adverse cardiovascular events are the leading cause of death in cancer patients. Chemotherapy, targeted therapies, immune checkpoint inhibition, and radiation therapy can all adversely impact cardiac function, and their effects can be synergistic. Consequently, it is important that possible side effects of therapy be recognized and effectively controlled. This review highlights the mechanisms and histopathologic findings associated with common forms of potentially cardiotoxic cancer therapy including anthracyclines, tyrosine kinase inhibitors, and most recently immune checkpoint (PD-1) inhibitors. Although for many cases the histologic findings are nonspecific, in the appropriate clinical context, therapeutic cardiotoxicity can be inferred and the treatment approach refined appropriately.

在美国，终身诊断癌症的风险接近40％；在2016年，这代表了将近160万新患者，尽管早期诊断和治疗有所进步，但仍有约35％的患者最终死于恶性肿瘤。幸运的是，患有癌症的患者也不断增加，预计在不到十年的时间里将超过1900万。因此，在计算治疗的相对风险和收益时，重要的是要考虑与抗肿瘤治疗本身相关的发病率和死亡率。值得注意的是，排除由恶性肿瘤本身引起的死亡，治疗引起的不良心血管事件是癌症患者死亡的主要原因。化学疗法，针对性疗法，免疫检查点抑制和放射疗法都会对心脏功能产生不利影响，它们的作用可以是协同的。因此，重要的是要认识到并有效控制治疗的可能副作用。这篇综述重点介绍了与潜在的心脏毒性癌症治疗的常见形式相关的机制和组织病理学发现，包括蒽环类药物，酪氨酸激酶抑制剂和最近的免疫检查点（PD-1）抑制剂。尽管在许多情况下，组织学检查结果是非特异性的，但在适当的临床环境中，可以推断出治疗性心脏毒性，并适当地完善了治疗方法。这篇综述重点介绍了与潜在的心脏毒性癌症治疗的常见形式相关的机制和组织病理学发现，包括蒽环类药物，酪氨酸激酶抑制剂和最近的免疫检查点（PD-1）抑制剂。尽管在许多情况下组织学检查结果是非特异性的，但在适当的临床背景下，可以推断出治疗性心脏毒性，并适当地完善了治疗方法。这篇综述重点介绍了与潜在的心脏毒性癌症治疗的常见形式相关的机制和组织病理学发现，包括蒽环类药物，酪氨酸激酶抑制剂和最近的免疫检查点（PD-1）抑制剂。尽管在许多情况下，组织学检查结果是非特异性的，但在适当的临床环境中，可以推断出治疗性心脏毒性，并适当地完善了治疗方法。