Radiation-induced pericarditis may trigger coronary vasospasm leading to myocardial infarction and variant angina, which can be responsive to corticosteroids.
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Corticosteroids may resolve refractory variant angina post-radiation; hypothesis-generating for pericarditis-triggered vasospasm.
A case of an acute myocardial infarction occurring in a 19-year-old woman, 27 months after mantle radiotherapy for Stage II-A Hodgkin's disease is described. The coronary arteriogram demonstrated patent and normal coronary arteries, but the echocardiogram revealed pericarditis. The clinical course was further complicated by variant type of angina pectoris which could not be prevented by treatment with vasodilators, but subsided promptly to corticosteroid therapy. It is suggested that radiation induced pericarditis triggered coronary vasospasm leading to the myocardial infarction and to variant angina pectoris.
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Yahalom et al. (1983) studied this question.
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