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Heart diseases following radiotherapy.

M F Chen1, C Y Yang, C C Wu

  • 1Department of Internal Medicine (Cardiology), National Taiwan University Hospital, Taipei, R.O.C.

Journal of the Formosan Medical Association = Taiwan Yi Zhi
|April 1, 1991
PubMed
Summary

Cardiac complications, including coronary artery disease and arrhythmias, can occur 10-17 years after breast cancer treatment (mastectomy and radiotherapy). These rare cases highlight the long-term cardiovascular risks associated with radiation therapy.

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Area of Science:

  • Cardiology
  • Oncology
  • Radiotherapy

Background:

  • Breast cancer treatment involving radical mastectomy and radiotherapy can have long-term sequelae.
  • Cardiac complications following cancer treatment are increasingly recognized.
  • Understanding the delayed effects of radiotherapy on the cardiovascular system is crucial.

Observation:

  • Three women aged 42-57 presented with cardiac issues 10-17 years post-treatment for left breast cancer.
  • Case 1: Precocious coronary artery disease (CAD) with stenosis and pericardial fibrosis, leading to death post-bypass surgery.
  • Case 2: Sick sinus syndrome with complete atrio-ventricular block, pericardial effusion, and valvular regurgitation, improved with pacemaker.
  • Case 3: Left anterior descending coronary artery stenosis and myocardial fibrosis, managed medically.

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Findings:

  • Radiation-induced cardiovascular damage can manifest years after treatment.
  • Observed complications include coronary artery disease, pericardial disease, conduction abnormalities, and valvular issues.
  • These cases represent rare but serious long-term effects of radiotherapy.

Implications:

  • Long-term cardiac surveillance is essential for breast cancer survivors treated with radiotherapy.
  • Further research is needed to elucidate the mechanisms of radiation-induced heart disease.
  • Developing strategies to mitigate cardiovascular risks in cancer patients is a priority.