Radiotherapy-induced isolated left main coronary artery disease presenting with cardiogenic shock
Abstract. Rationale:. Mediastinal radiotherapy is a common practice for treating breast cancer and Hodgkin's lymphoma. Radiotherapy causes cardiovascular damage and has attracted increasing attention, particularly among Hodgkin's lymphoma patients, as they receive a higher dose of radiatio...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2022-04-01
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| Series: | Medicine |
| Online Access: | http://journals.lww.com/10.1097/MD.0000000000029116 |
| _version_ | 1828283367439728640 |
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| author | Bo Li, MD Yuan Liu, MD Zhiyang Lou, RN Weihua Zhang, MD Mingyou Zhang, MD Quan Liu, MD Maya Saranathan. |
| author_facet | Bo Li, MD Yuan Liu, MD Zhiyang Lou, RN Weihua Zhang, MD Mingyou Zhang, MD Quan Liu, MD Maya Saranathan. |
| author_sort | Bo Li, MD |
| collection | DOAJ |
| description | Abstract. Rationale:. Mediastinal radiotherapy is a common practice for treating breast cancer and Hodgkin's lymphoma. Radiotherapy causes cardiovascular damage and has attracted increasing attention, particularly among Hodgkin's lymphoma patients, as they receive a higher dose of radiation.
Patient concerns:. A 36-year-old woman with a past medical history of Hodgkin's lymphoma presented with persistent chest pain for 3 hours. She experienced exertional chest pain 1 month before when she was climbing stairs, which disappeared after a few minutes with rest, but recurred with a similar level of exertion. Three hours before admission to the emergency room, the chest pain persisted and was accompanied by diaphoresis and dyspnea.
Diagnosis:. Cardiogenic shock caused by radiotherapy-induced left main coronary artery disease.
Interventions:. Urgent angiography revealed left main coronary artery stenosis. Intravascular ultrasonography showed diffuse fibrous proliferation in the left main coronary artery. Hemodynamic instability was resolved after drug-eluting stent implantation.
Outcomes:. The patient was discharged uneventfully 5 days after the procedure, with a prescription for dual antiplatelet and statin therapy. She was asymptomatic with good exercise tolerance at the 3-month follow-up.
Conclusion:. Radiotherapy-induced isolated left main coronary artery disease is a rare complication of cancer radiotherapy and can occur years or decades after treatment. Fibrous proliferation is a characteristic pathologic change in the exposed coronary arteries. |
| first_indexed | 2024-04-13T08:44:06Z |
| format | Article |
| id | doaj.art-3b544588032549b291c2a38b97da716e |
| institution | Directory Open Access Journal |
| issn | 0025-7974 1536-5964 |
| language | English |
| last_indexed | 2024-04-13T08:44:06Z |
| publishDate | 2022-04-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Medicine |
| spelling | doaj.art-3b544588032549b291c2a38b97da716e2022-12-22T02:53:45ZengWolters KluwerMedicine0025-79741536-59642022-04-0110116e2911610.1097/MD.0000000000029116202204220-00008Radiotherapy-induced isolated left main coronary artery disease presenting with cardiogenic shockBo Li, MD0Yuan Liu, MD1Zhiyang Lou, RN2Weihua Zhang, MD3Mingyou Zhang, MD4Quan Liu, MD5Maya Saranathan.6Department of Cardiovascular Medicine, The First Hospital of Jilin University, Changchun, China.Department of Cardiovascular Medicine, The First Hospital of Jilin University, Changchun, China.Department of Cardiovascular Medicine, The First Hospital of Jilin University, Changchun, China.Department of Cardiovascular Medicine, The First Hospital of Jilin University, Changchun, China.Department of Cardiovascular Medicine, The First Hospital of Jilin University, Changchun, China.Department of Cardiovascular Medicine, The First Hospital of Jilin University, Changchun, China.Department of Cardiovascular Medicine, The First Hospital of Jilin University, Changchun, China.Abstract. Rationale:. Mediastinal radiotherapy is a common practice for treating breast cancer and Hodgkin's lymphoma. Radiotherapy causes cardiovascular damage and has attracted increasing attention, particularly among Hodgkin's lymphoma patients, as they receive a higher dose of radiation. Patient concerns:. A 36-year-old woman with a past medical history of Hodgkin's lymphoma presented with persistent chest pain for 3 hours. She experienced exertional chest pain 1 month before when she was climbing stairs, which disappeared after a few minutes with rest, but recurred with a similar level of exertion. Three hours before admission to the emergency room, the chest pain persisted and was accompanied by diaphoresis and dyspnea. Diagnosis:. Cardiogenic shock caused by radiotherapy-induced left main coronary artery disease. Interventions:. Urgent angiography revealed left main coronary artery stenosis. Intravascular ultrasonography showed diffuse fibrous proliferation in the left main coronary artery. Hemodynamic instability was resolved after drug-eluting stent implantation. Outcomes:. The patient was discharged uneventfully 5 days after the procedure, with a prescription for dual antiplatelet and statin therapy. She was asymptomatic with good exercise tolerance at the 3-month follow-up. Conclusion:. Radiotherapy-induced isolated left main coronary artery disease is a rare complication of cancer radiotherapy and can occur years or decades after treatment. Fibrous proliferation is a characteristic pathologic change in the exposed coronary arteries.http://journals.lww.com/10.1097/MD.0000000000029116 |
| spellingShingle | Bo Li, MD Yuan Liu, MD Zhiyang Lou, RN Weihua Zhang, MD Mingyou Zhang, MD Quan Liu, MD Maya Saranathan. Radiotherapy-induced isolated left main coronary artery disease presenting with cardiogenic shock Medicine |
| title | Radiotherapy-induced isolated left main coronary artery disease presenting with cardiogenic shock |
| title_full | Radiotherapy-induced isolated left main coronary artery disease presenting with cardiogenic shock |
| title_fullStr | Radiotherapy-induced isolated left main coronary artery disease presenting with cardiogenic shock |
| title_full_unstemmed | Radiotherapy-induced isolated left main coronary artery disease presenting with cardiogenic shock |
| title_short | Radiotherapy-induced isolated left main coronary artery disease presenting with cardiogenic shock |
| title_sort | radiotherapy induced isolated left main coronary artery disease presenting with cardiogenic shock |
| url | http://journals.lww.com/10.1097/MD.0000000000029116 |
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