Key result
Thoracic radiation therapy in cancer patients is associated with valvular heart disease, necessitating echocardiographic evaluation and severity-guided follow-up.
Patients exposed to mediastinal radiotherapy are at risk for radiation-induced valvular heart disease and require regular echocardiographic follow-up based on the severity of valve dysfunction.
Radiation-induced VHD underrecognized in survivors; leaves open mechanistic studies and screening protocols.
Valvular heart diseases (VHD) may be observed in patients with cancer for several reasons, including preexisting valve lesions, radiotherapy, infective endocarditis, and secondary to the left ventricle dysfunction. The incidence of VHD is especially in younger survivors treated with thoracic radiation therapy for certain malignancies, such as Hodgkin's lymphoma and breast cancer. The mechanism of radiation-induced damage to heart valves is not clear and includes diffuse fibrocalcific thickening of the valve. VHD is commonly diagnosed after a long latent period, in the context of clinical symptoms, or suspected on the basis of a new murmur. The evaluation includes identification of anatomical valve abnormalities, valve dysfunction, and assessing the functional consequences of valve dysfunction on the ventricles. Echocardiography is the optimal imaging technique for diagnostic and therapeutic management. Cardiovascular magnetic resonance and computed tomography (CT) may be used to assess the severity of VHD, but cardiac CT is mainly useful for detecting extensive calcifications of the ascending aorta. Patients exposed to mediastinal radiotherapy and minimal valve dysfunction require follow-up of 2-3 years, with moderate valve disease yearly, with severe, should be assessed for valve surgery.
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Monte et al. (2020) conducted a review in Valvular heart diseases in cancer patients. Thoracic radiation therapy was evaluated. Thoracic radiation therapy in cancer patients is associated with valvular heart disease, necessitating echocardiographic evaluation and severity-guided follow-up.
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