Radiation Induced Heart Disease

From Anvita Health Wiki

Contents 1 Epidemiology 2 Pathology 3 Clinical-manifestations 4 Management 5 More General Terms 6 Additional Terms 7 References

Epidemiology

• increased likelihood with 3600-4000 Gy of cardiac radiation

Pathology

• myocardial fibrosis

• microvascular ischemia at the level of myocardial capillaries
• diastolic dysfunction is common

• effusive pericarditis

• most commonly during 1st 6 months after radiation
• generally asymptomatic
• appearance may be delayed for years

• constrictive pericarditis
• radiation induced valvular heart disease
• cardiac conduction system disease
• radiation-induced coronary artery disease ( CAD)

• distinct from atherosclerotic CAD
• tendency to involve osteal & proximal coronary arteries
• greater extent of intimal fibrosis & adventitial thickening

Clinical-manifestations

• effusive pericarditis

• generally asymptomatic
• occasionally patients complain of exertional dyspnea

• occult constrictive pericarditis

• unexplained exertional dyspnea
• occurs several years after radiation
• jugular venous distention may be noted
• no edema
• no pericardial knock

• symptoms associated with constrictive pericarditis

Management

• increased likelihood of atherosclerosis
• friability of internal mammary artery when used as a bypass conduit for CABG
• constrictive pericarditis

• seldom need pericardiectomy
• symptoms generally controlled with diuretics

• no established guidelines for long-term follow-up

More General Terms

• heart disease (cardiac disease)
• radiation injury; radiation toxicity

Additional Terms

• pericarditis
• radiation therapy (XRT)

References

Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998

radiation-induced heart disease