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Symptomatic CAD Pre-operative assessment of LIMA and RIMA viability, venous access, and sternal wound healing is recommended in CS with radiationinduced CAD where CABG is considered. I C Recommendation Table 44 for adult cancer survivors with valvular heart disease

A MDT approach is recommended to discuss and define the surgical risk in CS with severe VHD. I C

Recommendation Table 46 for cardiovascular monitoring in cancer survivors during pregnancy In high-risk female CS, pre-pregnancy counselling and management during pregnancy and around delivery by a multidisciplinary pregnancy heart team is recommended. I C A baseline CV evaluation including history, physical examination, ECG, NP, and echocardiography is recommended in female CS with a history of CTRCD who are considering pregnancy. I C A CV evaluation including echocardiography is recommended at 12 weeks of pregnancy in female CS who are either high-risk or who received potentially cardiotoxic cancer therapy and did not have a baseline CV assessment. I C Recommendation Table 47 for cardiovascular assessment and monitoring of pregnant women with cancer Management by an expert MDT (the pregnancy heart team) in an expert centre is recommended for pregnant women with cancer who require cardiotoxic cancer therapy. I C Cardiac assessment prior to cardiotoxic cancer therapy in pregnant women is recommended and consists of clinical history, physical examination, ECG, and echocardiography. I C Recommendation Table 48 for carcinoid valvular heart diseases Echocardiography is recommended for the detection of carcinoid cardiac involvement in all patients with carcinoid syndrome and elevated NP levels and/or clinical signs of carcinoid heart disease, and for surveillance every 3 or 6 months depending on the severity of cardiac involvement and clinical status. I B A MDT discussion for optimal medial management to prevent carcinoid crisis is recommended before any invasive or surgical cardiac procedure. I C Valve replacement surgery is recommended in symptomatic patients with severe carcinoid tricuspid or pulmonary VHD and an expected survival ≥12 months. I C Valve replacement or repair surgery is recommended in symptomatic patients with severe carcinoid mitral or aortic VHD and an expected survival ≥12 months. I C Recommendation Table 49 for amyloid light-chain cardiac amyloidosis diagnosis and monitoring

Echocardiography, NP, and cTn are recommended for the diagnosis of AL-CA in patients with plasma cell dyscrasia. I B

CMR is recommended in patients with suspected AL-CA. I A

Recommendation Table 50 for risk stratification and monitoring for patients with cardiac implantable electronic devices undergoing radiotherapy Risk stratification including planned radiation type and energy, dose to CIED, the patient’s device type, and pacing dependence is recommended prior to starting treatment. I C In patients undergoing RT, a CIED check is recommended in all patients before and after completing RT, and during RT according to individual risk. I C In patients with a CIED undergoing RT at high risk of arrhythmia and/or device dysfunction, ECG monitoring and/or pulse oximetry are recommended during every RT session. I C © ESC 2022

3D, three-dimensional; ACE-I, angiotensin-converting enzyme inhibitors; ACS, acute coronary syndromes; ADT, androgen deprivation therapy; AF, atrial fibrillation; AL-CA, amyloid light-chain cardiac amyloidosis; ALK, anaplastic lymphoma kinase;ARB, angiotensin receptorblocker; ASTCT, AmericanSociety for Transplantation and Cellular;AV, atrioventricular; BC, breast cancer; BCR- ABL, breakpoint cluster region–Abelson oncogene locus; BP, blood pressure; BTK, Bruton tyrosine kinase; CABG, coronary artery bypass graft; CAD, coronary artery disease; CAR-T, chimeric antigen receptor T cell; CCB, calcium channel blockers; CCS, chronic coronary syndromes; CCTA, coronary computed tomography angiography; CHA2DS2-VASc, Congestive heart failure, Hypertension, Age .75 years (2 points), Diabetes mellitus, Stroke (2 points)—Vascular disease, Age 65–74 years, Sex category (female); CIED, cardiac implantable electronic device; CMR, cardiac magnetic resonance; CRS, cytokine release syndrome; CT, computed tomography; cTn, cardiac troponin; CTRCD, cancer therapy-related cardiac dysfunction; CS, cancer survivors; CV, cardiovascular; CVD, cardiovascular disease; CVRF, cardiovascular risk factors; DAPT, dual antiplatelet therapy; EACTS, European Association for Cardio-Thoracic Surgery; ECG, electrocardiogram; EGFR, epidermal growth factor receptor; ESC, European Society of Cardiology; GLS, global longitudinal strain; HbA1c, glycated haemoglobin; HER2, human epidermal receptor 2; HF, heart failure; HSCT, haematopoietic stem cell transplantation; ICI, immune checkpoint inhibitors; ICU, intensive care unit; i.v., intravenous; LIMA, left internal mammary artery; LMWH, low-molecular-weight heparins; LQTS, long QT syndrome; LV, left ventricular; LVEF, left ventricular ejection fraction; MDT, multidisciplinary team; MEK, mitogen-activated extracellular signal-regulated kinase; MI, myocardial infarction; MM, multiple myeloma; NP, natriuretic peptides; NSTE-ACS, non-ST-segment elevation acute coronary syndromes; PAD, peripheral artery disease; PAH, pulmonary arterial hypertension; PI, proteasome inhibitors; QTc, corrected QT interval; QTcF, corrected QT interval using Fridericia correction; RAF, rapidly accelerated fibrosarcoma; RIMA, right internal mammary artery; RT, radiotherapy; SCORE2, Systematic Coronary Risk Estimation 2; SCORE2-OP, Systematic Coronary Risk Estimation 2— Older Persons; STEMI, ST-segment elevation myocardial infarction; TdP, torsade de pointes; TIL, tumour-infiltrating lymphocytes; TKI, tyrosine kinase inhibitors; TTE, transthoracic echocardiography; TTS, Takotsubo syndrome; TRV, tricuspid regurgitation velocity; ULN, upper limit of normal; VEGFi, vascular endothelial growth factor inhibitors; VHD, valvular heart disease; VTE, venous thromboembolism. aClass of recommendation. bLevel of evidence. Downloaded from academic.oup.com/eurheartj/article/43/41/4229/6673995 by guest on 07 October 2026