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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred twenty-four patients with seminoma (119 primary testis, five primary extragonadal) were treated between 1968 and 1984 at the Joint Center for Radiation Therapy. Fifty-seven of the 124 patients were treated with irradiation to the mediastinum as well as to an infradiaphragmatic field. One patient received supradiaphragmatic radiotherapy only. The remaining patients had radiation treatment limited to the infradiaphragmatic field only. Median dose to the mediastinum among the 58 patients was 2400 cGy. Four patients developed heart disease (one fatal myocardial infarction, one uncomplicated myocardial infarction, one constrictive pericarditis resulting in permanent total body anasarca, and one patient requiring aortic valve replacement and coronary artery bypass grafting for atherosclerotic disease) and two died suddenly. The two sudden deaths were thought to be cardiac in origin by the patient's primary physicians. All six complications occurred in the group that received mediastinal irradiation. No cardiac disease was manifested in the group not treated with mediastinal irradiation. This difference in the incidence of cardiac disease between the two groups is statistically significant (two sided, P = 0.019). Neither group had a statistically significant difference in cardiac disease rate from a normal population (Framingham study), although the ratio of observed to expected cardiac disease was 1.97 in the group receiving mediastinal radiation. Further experience from this and other institutions is necessary to confirm this finding.
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PMID:Cardiac disease after mediastinal irradiation for seminoma. 359

Twelve patients underwent cardiac surgical procedures after having previously received irradiation of the mediastinum for various types of malignancies (Hodgkin's disease, carcinoma of the breast and seminoma). The patients' ages ranged from 39 to 69 years (mean 57 years); nine patients were female and three male. The average length of time from radiation to surgery was 15 years (3-24 years interval). The patients were divided into two groups according to the type of heart disease: Group I included seven patients who developed coronary artery disease (CAD) despite minimal risk factors. Three asymptomatic patients developed sudden myocardial infarction. In two patients the myocardial infarction was complicated (with ventricular septal defect in one and ventricular septal defect plus ventricular aneurysm in the other). All seven patients were surgically managed. Internal thoracic artery (ITA) was used in three patients as a conduit of myocardial revascularization. There were two hospital deaths in this group. The five patients in Group II underwent aortic valve replacement for aortic stenoses. Prior to the irradiation, none of the patients had a documented history of rheumatic fever, bacterial endocartitis, significant murmur, etc. There were no deaths in this group. Intraoperative findings for both groups included thickening and/or fibrosis of the ascending aortic wall, coronary arteries and aortic valve tissue. Epicardium was whitish colored and thickened.
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PMID:Heart diseases following mediastinal irradiation: surgical management. 760 44

Radiation induced heart disease, with its clinical manifestations, is becoming a growing problem. Its prevalence is increasing, keeping pace with the increased survival of many malignancies. The majority of patients with radiation induced heart disease is constituted by Hodgkin's disease survivors, followed by non Hodgkin's disease, esophageal carcinoma, thymoma, lung cancer, breast cancer and metastatic seminoma. Pericardial disease is the most well known expression of radiation induced heart disease, although the whole cardiac structure is compromised because of the structural and consequently functional impairment. Myocardial damage can lead to a congestive heart failure, typically due to a restrictive cardiomyopathy. Coronary artery obstructive disease frequently involves ostial coronary segments and the left main, for this reason it does appear particularly harmful. All patients undergoing chest irradiation require serial cardiological evaluation. Important risk factors of radiation induced heart disease are previous chemotherapy, radiation exposition exceeding 4000 Rad, administration next to the heart and on the left side of the chest must be taken into particular consideration. The cardiac damage limitation basically is founded on prevention. Significant results have been obtained with fractional exposition, high energy utilization and "split" zone covering. The radiotherapeutic technical improvement with the comprehensive individual patient risk evaluation will provide a substantial benefit for the future. The consultant cardiologist should cooperate with the oncologist and the radiotherapist, providing specific competence and continuative care.
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PMID:Cardiac damage following therapeutic chest irradiation. Importance, evaluation and treatment. 1083 37

We report the case of a 33-year-old male with primary seminoma of the anterior mediastinum with initial clinical manifestations suggestive of heart disease.
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PMID:Cardiac extension of primary mediastinal seminoma compressing the right ventricular outflow tract. 1127 Mar 17