Jessica Shank Coviello, DNP, APRN, ANP-BC
Associate Professor of Nursing
Yale University School of Nursing
I hope you’ve been enjoying and learning from our new JADPRO Cardio-Oncology Updates offering! In addition to the current myriad drug class–specific resources—all curated by our expert faculty—the site now features a narrated Basics 101 presentation that you can view online or download and watch with your colleagues. This resource covers multiple important topics, including the link between cancer, treatment, and heart disease, current cardio-oncology standards of care, cancer treatment–related cardiotoxicity, and much more.
As we are all still experiencing, practicing in the age of COVID-19 is incredibly challenging. In cardio-oncology, this novel coronavirus has presented us with more than one reason for the cardiac side effects we commonly see with chemotherapy and/or radiation. COVID-19 has brought us heart failure, myocarditis, Takotsubo cardiomyopathy, and acute coronary syndrome (Ma L et al., 2020). We have commonly used ACE inhibitors and ARBs as cardio-protection during cancer therapy, but we now view them as possible contributors to blocking the renin-angiotensin pathway attenuating the severe lung injury seen with this viral infection. Research is still under way to answer the many questions we have about the role of ACE2 in COVID-19–induced cardiac injury and the mechanism of action that may produce this attenuation (Gosain R et al., 2020).
And as someone who uses their stethoscope as a diagnostic tool, COVID-19 has also inhibited my opportunity to lay hands on patients. I have become acutely aware of what we have taught our students over the years: the importance of a thorough history and thorough review of the medical record, which have now become the center piece of the assessment and plan of care. Even as an experienced clinician, I am becoming more of a master at digging in deep during the interview. The patient’s story is an important piece of the diagnosis puzzle, and our ability to think critically about their issue in the context of their overall clinical journey is all that some of us have right now to manage the complexities of their response to cancer treatment in the confines of the COVID-19 pandemic.
IJC Heart and Vasculature
European Journal of Cancer
Breast Cancer Research and Treatment
This activity is supported by Bristol-Myers Squibb and Pharmacyclics LLC.