Cardiotoxic drugs can impact the heart in various ways. They may cause arrhythmias, which are irregular heartbeats that can be life-threatening. Others can lead to cardiomyopathy, a disease of the heart muscle that makes it harder for the heart to pump blood. Some drugs might induce myocardial ischemia by reducing blood flow to the heart, while others can cause heart failure due to weakening of the heart muscle.