From the Guidelines

Yes, heart murmurs can be common in pediatric cancer patients, particularly those receiving certain chemotherapy agents such as anthracyclines 1.

The risk of cardiac toxicity is increased with higher cumulative doses of anthracyclines and chest radiation 1.
A thorough cardiac evaluation, including echocardiography, should be performed before, during, and after cancer treatment to detect any potential cardiac issues early on 1.
Regular follow-up appointments with a cardiologist are crucial to ensure prompt detection and management of any cardiac issues that may arise in children with cancer 1.

The American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend regular surveillance for cardiomyopathy in childhood cancer survivors treated with anthracyclines and/or chest radiation 1.
Medications like enalapril or carvedilol may be prescribed to help manage cardiac complications, but the specific treatment plan should be individualized and guided by a pediatric cardiologist or oncologist 1.
Novel imaging approaches, such as tissue Doppler imaging, CMR, and 3D echocardiography, may be used to detect early signs of cardiac dysfunction, but their routine use is not yet recommended due to limited availability and high costs 1.

The risk of cardiac toxicity can be long-lasting, and regular follow-up is essential to detect any potential cardiac issues early on 1.
Genetic susceptibility may play a role in modifying individual response to therapeutic exposures, and further research is needed to understand the pathogenesis of therapy-related cardiomyopathy 1.
Serum cardiac biomarkers, such as troponins and natriuretic peptides, may be used as complementary tools for detecting cardiomyopathy, but their diagnostic accuracy is still limited 1.

From the Research

Heart murmurs are not directly addressed in the provided studies as a common issue in pediatric cancer patients 2, 3, 4, 5, 6.
However, the studies discuss various symptoms and cardiotoxic effects associated with cancer treatment in children, such as asymptomatic electrocardiographic abnormalities, blood pressure changes, arrhythmias, myocarditis, pericarditis, and cardiac failure 2.
One study mentions that chest pain and heart murmurs are common issues that primary care providers must evaluate and manage in pediatric and adolescent patients, but it does not specifically address the prevalence of heart murmurs in pediatric cancer patients 3.
The other studies focus on symptoms such as pain, sadness, and symptom clusters in children receiving treatment for cancer, but do not provide information on heart murmurs 4, 5, 6.

The cardiotoxic effects of cancer treatment, including chemotherapy, can lead to various cardiac complications in pediatric cancer patients 2.
These effects may include asymptomatic electrocardiographic abnormalities, blood pressure changes, arrhythmias, myocarditis, pericarditis, and cardiac failure 2.
The studies emphasize the importance of primary and secondary prevention, including screening for risk factors, monitoring for signs and symptoms, and continuing follow-up to minimize the progression of left ventricular dysfunction to overt heart failure 2.