title: Cardiovascular complications of radiotherapy.
abstract: Chest radiotherapy is routinely used to treat malignancies such as Hodgkin disease and breast cancer but is commonly associated with a variety of cardiovascular complications involving the pericardium, myocardium, valves, coronary arteries, and conduction system. Cardiovascular complications are related to the total dose of radiation and the fractionation of the dose. They are usually progressive, portend poor prognosis, and are often refractory to treatment after significant radiation exposure. The mechanism of injury is multifactorial and likely involves endothelial damage of the microvasculature and coronary arteries and liberation of multiple inflammatory and profibrotic cytokines. In conclusion, routine follow-up with a cardiologist, which might include screening for valvular disease with echocardiography and coronary artery disease with computed tomography angiography or coronary artery calcium scoring, should be considered in patients with a history of chest radiotherapy.
authors.affiliation: Division of Cardiology, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California; Division of Cardiology, Department of Medicine, University of California, San Diego, La Jolla, San Diego, California. Electronic address: mslee@mednet.ucla.edu.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Lee
authors.forename: Will
authors.initials: W
authors.lastname: Finch
authors.forename: Ehtisham
authors.initials: E
authors.lastname: Mahmud
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology*; D006321:Heart / Q000528:radiation effects*; D006801:Humans; D011832:Radiation Injuries / Q000150:complications*; D013899:Thoracic Neoplasms / Q000532:radiotherapy*