Key result
Mediastinal radiation for Hodgkin's disease is linked to delayed fatal biventricular hypertrophy and extensive fibrosis.
Why the study?
The complex of myocardial hypertrophy, fibrosis, and infarction following radiation therapy for Hodgkin's disease has not been previously described or explained by other causes of heart muscle disease.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
Case suggests atypical radiation cardiomyopathy beyond CAD; leaves open full spectrum of thoracic irradiation effects.
A 35 year old man was treated for stage IIA Hodgkin's disease by radiation to the upper thorax, axillae and neck. Three years later he presented with intractable and ultimately fatal congestive heart failure. Autopsy revealed massive biventricular hypertrophy with widespread subendocardial fibrosis and myocardial infarction, but with little coronary artery disease. Such a complex of features has not previously been described after radiation therapy and cannot be adequately explained by other known causes of heart muscle disease. Ventricular hypertrophy with extensive subendocardial fibrosis may be part of the spectrum of radiation heart disease.
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O’Donnell et al. (1986) conducted a case report in Hodgkin's disease / Radiation heart disease (n=1). Radiation to the upper thorax, axillae and neck was evaluated. Radiation therapy for Hodgkin's disease was followed 3 years later by fatal congestive heart failure characterized by massive biventricular hypertrophy and widespread subendocardial fibrosis.
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