HER2 Support Group Forums - View Single Post - Herceptin side-effects

02-01-2006, 04:13 PM

I do not believe the literature addresses Herceptin causing problems with only one part or side of the heart--as I believe they are feeling the problem caused by herceptin is a GLOBAL one, affecting ALL parts of the heart made up of smooth muscle cells (all).They usually call it dilative cardiomyopathy. Although Herceptin appears to be involved in embryology of development of specific parts of the heart (trabeculae, electrical conduction system to some extent) in the adult the problems do not seem to be with one part of the heart (as it would be if the effect were electrical, mechanical or "plumbing" for example lack of contraction of just one of four chambers due to lack of blood supply to the electrical pathway going to that area, or lack of contraction of just one area of one chamber as might happen after a heart attack due to death of muscle cells in one area leaving just scar which cannot contract or narrowing of the arteries leaving the right side of the heart to go to the lungs which would cause the right side of the heart to back up (like a clogged rain gutter). Since herceptin seems to affect the subcellular organelles which produce energy in the smooth muscle cells that the entire heart is made out of the only difference in which chambers/side dilate(stretch out like a bathing suit which has been in the Jacuzzi too many times)and do not contract well probably has to do with which ones have to pump against gravity (ventricles) and how badly the next chamber on is backing up.

I believe Robin P is an ex cardiac ICU nurse from Johns Hopkins. Perhaps she could address this better than I can.

If your left ventricular ejection fraction is OK and your right one isn't, perhaps you have a second problem with your pulmonary vasculature
or the electricity, plumbing or mechanics of the right side of your heart.

A few teaching hospitals (Stanford among them) have 3 dimensional echo cardiograms(the ones commonly in use are 2d). They have not yet learned to charge differently for them so they do not use them routinely. If your cardiologist cannot figure out why the right side of your heart is differentially affected, perhaps he/she can refer you for one.

Again, maybe herceptin has some other effect we do not know about yet, or that I missed in my review of the Herceptin and heart problems literature in early December.

There is so much that is not known.

I am certainly no cardiologist!

Robin, any input?

02-01-2006, 04:13 PM	#4
Lani Guest Posts: n/a	Right vs left ventricular ejection fraction dysfunction --any literature? I do not believe the literature addresses Herceptin causing problems with only one part or side of the heart--as I believe they are feeling the problem caused by herceptin is a GLOBAL one, affecting ALL parts of the heart made up of smooth muscle cells (all).They usually call it dilative cardiomyopathy. Although Herceptin appears to be involved in embryology of development of specific parts of the heart (trabeculae, electrical conduction system to some extent) in the adult the problems do not seem to be with one part of the heart (as it would be if the effect were electrical, mechanical or "plumbing" for example lack of contraction of just one of four chambers due to lack of blood supply to the electrical pathway going to that area, or lack of contraction of just one area of one chamber as might happen after a heart attack due to death of muscle cells in one area leaving just scar which cannot contract or narrowing of the arteries leaving the right side of the heart to go to the lungs which would cause the right side of the heart to back up (like a clogged rain gutter). Since herceptin seems to affect the subcellular organelles which produce energy in the smooth muscle cells that the entire heart is made out of the only difference in which chambers/side dilate(stretch out like a bathing suit which has been in the Jacuzzi too many times)and do not contract well probably has to do with which ones have to pump against gravity (ventricles) and how badly the next chamber on is backing up. I believe Robin P is an ex cardiac ICU nurse from Johns Hopkins. Perhaps she could address this better than I can. If your left ventricular ejection fraction is OK and your right one isn't, perhaps you have a second problem with your pulmonary vasculature or the electricity, plumbing or mechanics of the right side of your heart. A few teaching hospitals (Stanford among them) have 3 dimensional echo cardiograms(the ones commonly in use are 2d). They have not yet learned to charge differently for them so they do not use them routinely. If your cardiologist cannot figure out why the right side of your heart is differentially affected, perhaps he/she can refer you for one. Again, maybe herceptin has some other effect we do not know about yet, or that I missed in my review of the Herceptin and heart problems literature in early December. There is so much that is not known. I am certainly no cardiologist! Robin, any input?