Radiation-induced coronary artery disease in Hodgkin's disease.
OBJECTIVE
Secondary malignant tumours and cardiovascular complications are of great importance among the late complications after treatment for Hodgkin's disease (HD) because they may significantly reduce the patients' life expectancy. We report on coronary artery disease (CAD) after treatment for HD.


METHODS
We present the case of two female patients with HD who received mediastinal irradiation after which complete remission was achieved. In 12 and 19 years after the onset of the disease, control examinations revealed ischaemic heart disease, which was confirmed by coronary arteriography and solved by stent implantation in one of the patients and bypass surgery in the other one.


CONCLUSIONS
Ischaemic heart disease was due to early CAD, which was associated with mediastinal irradiation accompanied by hypothyroidism, hyperlipidaemia and, possibly, early menopause, all posing an increased risk for the cardiologic disease. Our cases may serve as a warning example to carefully plan the management (low dose, involved field irradiation) of newly diagnosed patients as well as the cardiologic follow-up of patients with HD.
3rd Department of Medicine, Medical and Health Science Center, University of Debrecen, Móricz Zs. krt. 22, 4004 Debrecen, Hungary. mil03@freemail.hu
Zsófia
Z
Miltényi
Katalin
K
Keresztes
Ildikó
I
Garai
István
I
Edes
Zoltán
Z
Galajda
László
L
Tóth
Arpád
A
Illés
D000328:Adult; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D001707:Biopsy, Needle; D001918:Brachytherapy / Q000009:adverse effects*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000175:diagnosis / Q000532:radiotherapy*; D006801:Humans; D007150:Immunohistochemistry; D011832:Radiation Injuries / Q000473:pathology* / Q000628:therapy; D011879:Radiotherapy Dosage; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome