[Multiple cavities in myocardium of left ventricle after irradiation therapy for breast cancer: a case report].
A 68-year-old woman was admitted to our hospital with congestive heart failure. She had been diagnosed with hypertrophic cardiomyopathy 12 years ago in another hospital. She had received irradiation therapy for left breast cancer 33 years ago after resection of her left breast. Echocardiography revealed left ventricular hypertrophy and wall motion hypokinesis, and multiple cavities in the myocardium of the left ventricle, interventricular septum, and anterior wall. Some cavities were observed to connect to the left ventricular cavity and Doppler echocardiography showed slow velocity flows in them different from that of the coronary artery. The pathologic diagnosis was severe sclerosis of the left coronary artery, especially the left descending artery and its branch, which was the area with irradiation. Histopathology revealed sclerotic changes of the coronary artery causing acute and chronic myocardial infarction, and incomplete regeneration and hypertrophy of cardiac cells. There was no sign of hypertrophic cardiomyopathy. Myocardial degeneration and deciduation were present next to the cavities connected to left ventricle-like fistulas.
Miyake
S
S
Department of Internal Medicine, Nishi-Kobe Medical Center.
Kato
H
H
Koizumi
K
K
Eizawa
H
H
Hashimoto
K
K
Maenishi
F
F
Horikawa
R
R
Sakakibara
Y
Y
Noborio
K
K
Uchida
H
H
Azuma
S
S
Nishida
N
N
Yutani
C
C
D000368:Aged; D001943:Breast Neoplasms / Q000532:radiotherapy*; D002312:Cardiomyopathy, Hypertrophic / Q000175:diagnosis; D003324:Coronary Artery Disease / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology / Q000528:radiation effects; D003937:Diagnosis, Differential; D015150:Echocardiography, Doppler; D005260:Female; D006352:Heart Ventricles / Q000473:pathology* / Q000528:radiation effects*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology; D011878:Radiotherapy / Q000009:adverse effects