711 CROSS-SECTIONAL ANALYSIS OF CARDIOVASCULAR CAUSES OF COMMON PRESENTING SYMPTOMS IN PATIENTS WITH ACTIVE CANCER: THE EXPERIENCE FROM A TERTIARY ONCOLOGICAL CENTRE IN MODENA. (15th December 2022) - Maisano, Anna
Abstract: Background and aim of the study: There is a rising interest in cardio-oncology as an holistic approach to oncological patients with established cardiovascular comorbidities or at increased cardiovascular risk. Symptoms of potential cardiovascular significance are a common cause of cardiologic consultation in patients with active cancer. Moving from this perspective, we analyzed the proportion of cardiovascular conditions underpinning potentially cardiologic presenting symptoms in a cohort of patients with active malignancy referred to the Emergency Department (ER) of a tertiary oncological centre. Methods and Results: The study included 250 consecutive patients (median age 69 years [IQR 59.7-77.4], 50% female) presenting to the oncologic ER from September 1 st 2021 to May 31 st 2022. The most common presenting symptoms were fever (26.9%), gastrointestinal symptoms (24.9%), dyspnea (10.4%), hypotension and hypertension (1.6%), syncope (1.2%) and other (11.2%). We considered as symptoms of potential cardiologic significance the following: dyspnea, lipothymia and syncope, palpitations, fever, chest pain, hypotension and hypertension. We found that 101 of 250 patients (40%) presented with symptoms of potential cardiologic significance. Out of them, 14 patients (13.9%) had confirmed cardiologic diseases: pulmonary embolism (21.4%), heart failure (21.4%), pericardial effusion (21.4%), reflex syncope (14.2%), pericarditis (14.2%) and new onset atrial fibrillation (7.1%). As reported in the table, no significant difference was reported in terms of risk profile or history of cardiac diseases when comparing patients with and without cardiovascular cause of presenting symptoms (CV cause vs non-CV cause). Conclusions: Cardiovascular conditions are not common causes of ER presentation among oncologic patients with active cancer. Nevertheless, when a cardiologic condition is diagnosed, it could be potentially life-threatening. The cardiovascular risk profile and the history of cardiac disease is not a good discriminator to identify a cardiac cause of presenting symptoms in this specific setting. Table. Characteristics of patients with potentially cardiologic presenting symptoms.