Which of the following are exercise-related red flags in individuals exposed to anthracyclines?

• A. Chest discomfort during rest
• B. Unusual breathlessness, excessive fatigue, chest discomfort
• C. Occasional leg cramps during exercise
• D. No symptoms during activity

Answer: (B)

Exertional symptoms reveal potential cardiotoxic effects from anthracycline exposure. These drugs can impair the heart’s pumping ability, so during exercise the body’s demands rise and signs of cardiac trouble often appear as unusual breathlessness, excessive fatigue, and chest discomfort. Together, these symptoms during activity indicate that the heart may not be meeting the increased demands, signaling the need for medical evaluation before continuing exercise.

Chest discomfort at rest, leg cramps during exercise, or having no symptoms during activity are not as specifically tied to exercise-related cardiac dysfunction from anthracyclines. Resting chest pain can have other causes, leg cramps might be musculoskeletal or vascular and not necessarily cardiotoxicity, and no symptoms during activity doesn’t raise concern for hidden cardiac issues.