Paediatric oncology patients with left ventricular dysfunction should be prescribed ACEIs or beta blockers regardless of heart failure symptoms, according to world-first guidance.

Three-dimensional transthoracic echocardiogram (TTE) is also the preferred imaging modality for measuring left ventricular ejection function using global longitudinal strain, the Australian authors say.

Although cardiac complications are a leading cause of death in childhood cancer survivors — second only to relapse — the guidelines are the first to specifically focus on managing cardiotoxicity in children undergoing cancer therapy.

Co-author Associate Professor Rachel Conyers, from the Murdoch Children’s Research Institute in Melbourne, said the document would be an indispensable tool for clinicians in the cardio-oncology field.