[Radiation-induced coronary artery disease. One observation (author's transl)]

Twenty-seven reports (26 from the literature) of radiation ischemic heart diseases are studied in order to specify their clinical and pathological findings and their natural history. This complications appear after treatment of radiation-curable diseases with a mean delay of 4 years in young patients (mean age of 31). Several coronary arteries are often injured with fibrous and or atherosclerotic anatomical lesions. The frequency of this coronary artery diseases is certainly more important than reported since they are often latent but probably progressive. However, atherogenic factors increase the risk and must be lowered in a preventive aim; as a rule, the radiotherapeutic technique must also be as perfect as possible. The prognosis of this radiation induced coronary artery diseases is poor: 19 myocardial infarctions and 12 deaths are observed but no cardiac death occurred in patients who received a by-pass graft. So, radiation ischemic heart disease needs active investigation and therapy.