Radiation-induced ostial stenosis of the coronary artery as a cause of acute coronary syndromes: a novel mechanism of thrombus formation?
Mediastinal irradiation can induce coronary artery disease characterized by fibrous lesions developing in the absence of lipid/foam cell accumulation. We document several consecutive cases of acute coronary artery occlusion developing over radiation-induced lesions in patients who were relatively young, without evidence of classical risk factors for atherosclerosis, and in whom the coronary vasculature was otherwise apparently free of disease. The finding of acute coronary artery occlusion at the site of a fibrous lesion lends further support to the hypothesis that acute coronary syndromes may not necessarily be identifiable with ulceration/disruption of the atherosclerotic plaque as the underlying mechanism of acute thrombus formation.
Notaristefano
Salvatore
S
Division of Cardiology, University of Perugia School of Medicine, Perugia, Italy.
Giombolini
Claudio
C
Santucci
Stefano
S
Fortunati
Federico
F
Del Pinto
Maurizio
M
Tritto
Isabella
I
Notaristefano
Antonio
A
Ambrosio
Giuseppe
G
D000016:Abnormalities, Radiation-Induced / Q000175:diagnosis / Q000209:etiology*; D000208:Acute Disease; D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000175:diagnosis / Q000209:etiology*; D023921:Coronary Stenosis / Q000175:diagnosis / Q000209:etiology; D003328:Coronary Thrombosis / Q000150:complications / Q000175:diagnosis; D003331:Coronary Vessels / Q000528:radiation effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013577:Syndrome