Cardiac Toxicology

The cardiovascular system is the most important organ system required for human life. Toxicity to the component parts of the cardiovascular system can lead to death or devastating irreparable damage to the normal functioning of the organ systems of the human body. Many industrial and pharmaceutical chemicals can exert toxic action on various components of the cardiovascular system. Chemicals that target the heart are classed as cardiotoxins and can exert their effects directly or indirectly. The dosage and exposure period influence the effects these chemicals may exert on the heart. Cardiotoxins can alter the heart functionally or structurally. Functional alterations, such as the induction of arrhythmias, affect the normal physiological performance of the heart. Cardiotoxins may also selectively induce structural damage by altering the heart's cellular components. Structural cardiotoxins may directly affect cardiomyocyte membrane integrity, ion transport and energy supply systems. Cardiotoxic agents, chemically classed as plant- and animal-derived toxins, heavy metals, aliphatic alcohols and hydrocarbons, aldehydes, gases (CO), carcinogens, and pharmaceutical agents utilized in the treatment of cancer, high blood pressure (antihypertensive drugs), arrythmias and depression (tricyclic antidepressants), and anesthetics (such as bupivacaine and halogenated hydrocarbon anesthetics) and their mechanisms of toxicity are reviewed. Environmental pollutants, including particulate matter, polyaromatic hydrocarbons and metals, which are suspected cardiotoxic agents, are briefly highlighted.

Keywords: heart; cardiotoxic chemicals; pharmaceuticals and industrial agents