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The field of Cardio-Oncology has grown significantly, especially during the last decade. While awareness of cardiotoxicity due to cancer disease and/or therapies has greatly increased, much of the attention has focused on myocardial systolic disfunction and heart failure. However, coronary and structural heart disease are also a common issue in cancer patients and encompass the full spectrum of cardiotoxicity. While invasive percutaneous or surgical intervention, either is often needed or considered in cancer patients, limited evidence or guidelines are available for dealing with coronary or structural heart disease. The Society for Cardiovascular Angiography and Interventions consensus document published in 2016 is the most comprehensive document regarding this particular issue, but relevant evidence has emerged since, which render some of its considerations outdated. In addition to that, the recent 2022 ESC Guidelines on Cardio-Oncology only briefly discuss this topic.As a result, the Portuguese Association of Cardiovascular Intervention and the Cardio-Oncology Study Group of the Portuguese Society of Cardiology have partnered to produce a position paper to address the issue of cardiac intervention in cancer patients, focusing on percutaneous techniques. A brief review of available evidence is provided, followed by practical considerations. These are based both on the literature as well as accumulated experience with these types of patients, as the authors are either interventional cardiologists, cardiologists with experience in the field of Cardio-Oncology, or both. Resumo: A Cardio-Oncologia cresceu consideravelmente, particularmente ao longo da última década. Não obstante o aumento de sensibilização relativamente à cardiotoxicidade secundária ao cancro e/ou a terapêuticas oncológicas, muita da atenção tem-se focado na disfunção sistólica e insuficiência cardíaca. Todavia, a doença coronária e estrutural cardíaca representam também um desafio comum em doentes oncológicos, fazendo assim parte do abrangente conceito de Cardio-Oncologia. Apesar da necessidade de intervenção invasiva, percutânea ou cirúrgica ser frequentemente necessária ou considerada em doentes com cancro, é escassa a evidência ou recomendações relativas à doença coronária ou estrutural neste subgrupo. O documento de consenso da Society for Cardiovascular Angiography and Interventions, publicado em 2016, é a referência mais completa relativamente a esta problemática. Contudo, alguma evidência que entretanto surgiu torna necessária uma atualização. Adicionalmente, as recentes recomendações de 2022 em Cardio-Oncologia da Sociedade Europeia de Cardiologia abordam este assunto somente de forma muito sucinta.Por este motivo, a Associação Portuguesa de Intervenção Cardiovascular e o Grupo de Estudos de Cardio-Oncologia associaram-se para produzir um Artigo de Posição sobre Intervenção Cardíaca em doentes com cancro, com foco nas técnicas percutâneas. Procedeu-se a uma breve revisão da literatura, seguida de considerações práticas. Estas baseiam-se na evidência disponível, bem como na experiência acumulada dos autores, que são Cardiologistas de Intervenção, Cardiologistas dedicados à área da Cardio-Oncologia, ou ambos.

In Portugal, up to 38% of the population has cardiovascular disease, which highlights the importance of primary health care (PHC) in its management. Adequate management of people with cardiovascular disease often requires hospital referral for a cardiology consultation. However, it is not always easy to ascertain which situations should be referred, especially given that PHC does not have access to all diagnostic exams recommended by international guidelines, such as natriuretic peptides in heart failure or computed tomography coronary angiogram in chronic coronary syndromes, among others. The aim of this document is to describe a practical approach to the most frequent heart diseases that may require a referral for a hospital cardiology consultation. Thus, in the different chapters, the recommendations for referral are highlighted generically according to group of disease, as well as, albeit briefly, the initial clinical approach within the scope of PHC for a differential diagnosis and more efficient follow-up. A modified Metaplan methodology was used. A panel of 4 cardiology specialists and 3 specialists in General and Family Medicine developed this document, which should not be taken as an official guideline, but as additional guidance for the correct referral of patients. It is therefore advisable to validate these recommendations locally with the referral hospital, as well as to be aware of the respective international and national guidelines., (Copyright © 2022 Sociedade Portuguesa de Cardiologia. Publicado por Elsevier España, S.L.U. All rights reserved.)