title: Extensive radiation-induced heart disease in an adult patient treated for lymphoma as a child.
abstract: Cardiovascular complications are the second leading cause of late mortality in survivors of Hodgkin's lymphoma (HL) exposed to mediastinal radiotherapy. Symptomatic cardiac disease following classic thoracic irradiation for HL is reported in 10%-30% of patients at 5-10 years of follow-up. We present the case of a 44-year-old man with a history of left cervical nodular lymphocyte predominant HL treated at childhood with 40 Gy extended field thoracic irradiation (Mantle) who presented with mixed aortic and mitral valve disease, coronary artery stenosis, myocardial and aortic calcifications, and mediastinal fibrosis. Despite extensive cardiac surgery, the postoperative course was complicated and resulted in the patient's death. We review herein the typical cardiac involvement related to mediastinal radiotherapy and the controversies surrounding its surgical approach.
authors.affiliation: Department of Medicine, Montreal Heart Institute, University of Montreal, Montreal, Québec, Canada.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Poulin
authors.forename: Alexandre
authors.initials: A
authors.lastname: Semionov
authors.forename: Philippe
authors.initials: P
authors.lastname: Roméo
authors.forename: Philippe
authors.initials: P
authors.lastname: Demers
authors.forename: Josephine
authors.initials: J
authors.lastname: Pressacco
authors.forename: Arsène
authors.initials: A
authors.lastname: Basmadjian
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D006328:Cardiac Catheterization; D002648:Child; D018450:Disease Progression; D017809:Fatal Outcome; D006331:Heart Diseases / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D006689:Hodgkin Disease / Q000175:diagnosis / Q000532:radiotherapy*; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D008297:Male; D011183:Postoperative Complications / Q000503:physiopathology; D011832:Radiation Injuries / Q000175:diagnosis* / Q000628:therapy; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy / Q000009:adverse effects; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D014057:Tomography, X-Ray Computed