Radiation-related chronic heart disease.
Three cases of radiation-related chronic heart disease are reported. All three patients had been treated for Hodgkin's disease with a mantle technique six to ten years earlier. Ten years after radiation treatment, a 34-year-old woman had dyspnea during exercise. Her heart was enlarged, and an ECG showed a RBBB. An echocardiogram showed pericardial effusion. Right-sided catheterization revealed an infundibular stenosis. A 31-year-old man had chest pain nine years after radiation. An ECG showed complete RBBB and an exercise stress test signs of ischemia; a coronary angiogram showed three proximal stenoses; and an echocardiogram revealed pericardial effusion. A 12-year-old boy had angina pectoris six years after radiation; one year later, he suffered an acute posterior infarction. Two weeks later he died suddenly. An autopsy showed a severe fibrotic and calcified narrowing of the proximal part of the left main coronary artery. Regardless of the patient's age, radiation-related cardiac complications must be kept in mind. Echocardiograms and, in cases of chest pain, exercise stress tests should be a part of routine postradiation follow-up.
D000328:Adult; D000787:Angina Pectoris / Q000209:etiology; D002037:Bundle-Branch Block / Q000209:etiology; D006328:Cardiac Catheterization; D002648:Child; D002908:Chronic Disease; D003327:Coronary Disease / Q000209:etiology; D003331:Coronary Vessels / Q000473:pathology; D004562:Electrocardiography; D005260:Female; D006331:Heart Diseases / Q000209:etiology*; D006689:Hodgkin Disease / Q000532:radiotherapy; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology; D010490:Pericardial Effusion / Q000209:etiology / Q000503:physiopathology; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D013997:Time Factors