Radiation-induced coronary artery disease in Hodgkin's disease

Zsófia Miltényi , Katalin Keresztes , Ildikó Garai , István Édes , Zoltán Galajda , László Tóth , Árpád Illés
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引用次数: 23

Abstract

Purpose

Secondary malignant tumours and cardiovascular complications are of great importance among the late complications after treatment for Hodgkin's disease (HD) because they may significantly reduce the patients' life expectancy. We report on coronary artery disease (CAD) after treatment for HD.

Methods and Materials

We present the case of two female patients with HD who received mediastinal irradiation after which complete remission was achieved. In 12 and 19 years after the onset of the disease, control examinations revealed ischaemic heart disease, which was confirmed by coronary arteriography and solved by stent implantation in one of the patients and bypass surgery in the other one.

Conclusions

Ischaemic heart disease was due to early CAD, which was associated with mediastinal irradiation accompanied by hypothyroidism, hyperlipidaemia and, possibly, early menopause, all posing an increased risk for the cardiologic disease. Our cases may serve as a warning example to carefully plan the management (low dose, involved field irradiation) of newly diagnosed patients as well as the cardiologic follow-up of patients with HD.

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何杰金氏病放射诱导冠状动脉病变
目的:在霍奇金病(HD)治疗后期并发症中,继发性恶性肿瘤和心血管并发症是非常重要的,因为它们可能显著降低患者的预期寿命。我们报道冠心病治疗后的冠状动脉疾病(CAD)。方法和材料我们报告了两例女性HD患者接受纵隔照射后完全缓解的病例。发病后12年和19年,对照检查显示缺血性心脏病,经冠状动脉造影确诊,1例患者行支架置入术,1例患者行搭桥手术。结论缺血性心脏病是由早期冠心病引起的,与纵隔照射伴甲状腺功能减退、高脂血症和可能的早期绝经有关,这些都增加了心血管疾病的风险。我们的病例可以作为一个警示的例子,仔细规划新诊断患者的管理(低剂量,涉及野照射)以及HD患者的心脏学随访。
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