Long-term cardiovascular evaluation of patients with Hodgkin's disease treated by thoracic mantle radiation therapy.
The long-term cardiac effects of anterior-weighted thoracic mantle field radiotherapy were assessed in 25 patients treated for Hodgkin's disease. These patients underwent an evaluation that included a careful history and physical examination, ECG, M-mode echocardiogram, exercise ECG-gated radionuclide ventriculography, and cardiac catheterization. In these 25 patients evaluated 37-144 months (median, 96) after completion of thoracic mantle radiotherapy, eight had constrictive pericarditis; eight had occult constrictive pericarditis; three had an abnormal response to fluid challenge; three had suspected or proven occlusive coronary artery disease; and one each had a cardiomyopathy and diminished functional capacity on exercise testing. Only one patient appears to be normal after evaluation. The clinical spectrum of delayed-appearing radiation-induced cardiac disease in patients treated by anterior-weighted thoracic mantle fields and our suggestions for its treatment are discussed.
D000293:Adolescent; D000328:Adult; D009202:Cardiomyopathies / Q000175:diagnosis / Q000209:etiology; D002648:Child; D003327:Coronary Disease / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology*; D006689:Hodgkin Disease / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D010494:Pericarditis, Constrictive / Q000175:diagnosis / Q000209:etiology*; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects*