Late Cardiac Effects of Therapeutic Mediastinal Irradiation

Abstract

Although the heart was formerly thought to be relatively resistant to radiation,1 the increasing use of radiation therapy to the mediastinum has been associated with well-documented instances of cardiac abnormalities, including pericarditis with effusion and tamponade,2 3 4 5 6 7 coronary-artery fibrosis and myocardial infarction,7 8 9 10 and constrictive pericarditis.6 , 11 Complications occurring within the first 12 to 24 months after treatment are well known2 3 4; nevertheless, the success of radiation in treating malignant conditions — particularly Hodgkin's disease — has led to its use in a sizable number of patients, who may be at risk for cardiac complications many years after therapy. Therefore, we used noninvasive . . .