Heart Health

Cardio-Oncology

Arkansas Cardiology and Baptist Health Heart Institute in Little Rock, Arkansas, is the proud home of the state’s first and only cardio-oncology clinic. Under the leadership of Ramey Marshell, MD, and Stephen Greer, MD, FACC, this clinic focuses on preventing and managing cardiovascular complications among cancer survivors and patients battling the disease. As cancer therapy has improved, there has been a dramatic increase in cancer-related survival. However, for some, this has come at the cost of either temporary or long-term adverse cardiovascular effects. 

Cardiologists Dr. Marshell and Dr. Greer created this clinic to form a collaborative relationship made up of a multidisciplinary team of cardiac specialists and cancer specialists such as oncologists, hematologists, radiation oncologists, surgical oncologists, oncology pharmacists, and more. The clinic’s primary objective is to help patients receive the best cancer therapy— with minimal delays or interruption— while minimizing potential adverse effects on the heart.

The Arkansas Cardiology Cardio-Oncology team offers a fully comprehensive service dedicated to the prevention and management of potential cardiomyopathy/heart failure, hypertensive disorders, cardiovascular complications, arrhythmias, conduction disorders, valvular disorders, myocardial inflammatory conditions, and more. Ranging from pre-treatment screening to optimization of medication regimens, initiation of preventive therapies, development of personalized monitoring plans, and long-term post-treatment surveillance, our hope is to support these patients throughout their course of treatment and beyond. 

Patient Information

At-Risk Patients for Cardiovascular Side Effects: 

  • Pre-existing cardiovascular disease– hypertension, hypercholesterolemia, coronary artery disease, congestive heart failure, peripheral artery disease, history of stroke, history of arrhythmias (e.g., atrial fibrillation), type II diabetes mellitus, longtime/ongoing smokers, and family history of cardiovascular disease
  • Breast cancer– related to drug therapies and left breast radiation
  • Hodgkin’s disease– related to drug therapies and radiation
  • Non-Hodgkin’s lymphoma– related to drug therapies and chest radiation
  • Lung cancer– related to drug therapies and radiation
  • Kidney cancer– related to drug therapies
  • Thyroid cancer– related to drug therapies 
  • Gastroesophageal cancer– related to drug therapies
  • Colon cancer– related to drug therapies
  • Liver cancer– related to drug therapies 
  • Prostate cancer– related to drug therapies
  • Acute childhood leukemia– related to drug therapies
  • Multiple myeloma– related to drug therapies
  • Lymphoma– related to drug therapies
  • Chronic myeloid leukemia–  related to drug therapies
  • Sarcoma– related to drug therapies
  • Pancreatic cancer– related to the disease itself and drug therapies 

General Principles of Cardio-Oncology Care at Arkansas Cardiology

  • A patient-centered approach to screening, monitoring, and treatment 
  • Baseline comprehensive CV risk assessment
  • Determination of estimated risk for development of potential cancer therapy-related cardiotoxicities and anticipated symptoms to watch out for
  • A personalized plan for monitoring (based on estimated risk)
  • Optimization of baseline CV disease and risk factors 
  • Determination of need for potential cardio-protective preventive therapy 
  • Multi-disciplinary discussion (between cancer and cardiac specialists) regarding potential need to alter, withhold or stop cancer treatments in those affected by significant cardiac toxicities and/or in those determined to be at a very high risk
  • Availability of all major advanced cardiac imaging modalities, as needed (e.g., transesophageal echocardiography with strain, cardiac/coronary CT, cardiac MRI, nuclear cardiology)
  • Availability of all major CV sub-specialists, as needed (i.e., interventional cardiologists, structural cardiologists, electrophysiologists, advanced heart failure specialists, cardiothoracic surgeons)