Radiation-Induced Coronary Artery Disease

This Points to Remember column discusses radiation-induced coronary artery disease (RICAD), a distinct and increasingly recognized cause of CAD among cancer survivors after receiving chest radiation therapy. RICAD typically presents years or even decades after mediastinal radiation therapy, often affecting young patients without traditional cardiovascular risk factors. Unlike typical atherosclerosis, RICAD is driven by chronic inflammation and fibrosis. Clinicians should maintain a high index of suspicion in cancer survivors, and management often favors medical therapy and percutaneous coronary intervention when indicated.