Important factors for anti-HER2 drug-induced cardiotoxicity are of high risk in previous cardiovascular disease (very high in pre-existent HF or cardiomyopathy, high after myocardial infarction or in severe valvular disease, reduced LVEF < 50%), and medium risk even in borderline LVEF, arterial hypertension, obesity, smoking, chronic kidney disease, older age > 65 years (high risk > 80 years) or after radiation to the chest [2, 20, 37]. This evidence concerns the gene ERBB2 and hydrops fetalis.