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Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient with a history of Hodgkin's lymphoma presented with recurrent left pleural effusions and dyspnea on exertion 27 years after radiation therapy. Further evaluation disclosed suspected radiation-induced constrictive pericarditis, aortic stenosis and regurgitation, and severe coronary artery disease. He underwent successful 3-vessel coronary artery bypass grafting, aortic valve replacement, and pericardiectomy.
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PMID:Three-vessel coronary artery disease, aortic stenosis, and constrictive pericarditis 27 years after chest radiation therapy: a case report. 1684 29

We describe the case of a 31-year-old man who experienced an acute myocardial infarction 16 years after undergoing radiation and vinca alkaloid therapy for Hodgkin's disease. Even though coronary artery disease is a well-established complication after mediastinal radiation therapy, this adult patient had normal coronary angiographic results, with no traditional risk factors for coronary artery disease, and no hematologic or other abnormality associated with hypercoagulability.
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PMID:Acute myocardial infarction with normal coronary arteries in a patient with Hodgkin's disease: a late complication of irradiation and chemotherapy. 1742 Aug 16

Mediastinal irradiation has been a major component of the treatment of Hodgkin disease as well as breast and lung tumors. A potentially devastating posttreatment complication of mediastinal irradiation is the development of premature coronary artery disease. Coronary bypass grafting in such patients is difficult because of the presence of extensive radiation-induced mediastinal fibrosis. We present a rare case of patient with non-small-cell lung cancer who underwent successful coronary bypass grafting despite having previously received full-dose thoracic irradiation in conjunction with concurrent chemotherapy.
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PMID:Successful coronary artery bypass grafting after concurrent chemoradiation therapy in a patient with non-small-cell lung cancer: case report and review of the literature. 1723 99

Mediastinal irradiation is a known cause of late onset cardiac complications including coronary artery disease. We describe a 58-year-old female patient, without any of the traditional coronary risk factors, who presented with inferior infarction 23 years after radiotherapy for Hodgkin's lymphoma of the mediastinum. Coronary angiography demonstrated severe ostial stenoses of both coronary arteries. The patient underwent coronary artery bypass grafting and is doing well 10 months later. The therapeutic value of mediastinal irradiation is unquestionable. However, it may be associated with late complications from the irradiated tissues, including the heart. Long-term follow up of cancer survivors who have received mediastinal irradiation should therefore include annual cardiac ultrasound examinations, as well as functional testing for the detection of myocardial ischaemia.
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PMID:Coronary artery disease following mediastinal irradiation. 1762 83

A 34-year-old woman developed chest pain during exercise. She had been treated for Hodgkin lymphoma with irradiation (mantle field) and cytotoxic drugs (ABVD) 15 years earlier, and had risk factors for coronary artery disease (smoker status and family history). An exercise ECG showed significant ST depressions and an echocardiogram was normal. She underwent coronary angiography, which revealed three vessel disease (including stenosis of the left main stem); bypass grafting was successfully performed. This case illustrates the fact that even young women may develop extensive coronary disease and that development of coronary artery disease may be accelerated after irradiation of the thorax.
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PMID:[Chest pain in a woman previously treated with irradiation]. 1824 Mar 95

Chest irradiation and chemotherapy may lead to precocious coronary artery disease due to accelerated atherosclerosis or fibrointimal hyperplasia. Three cases of women (43, 50, and 53 years old) without typical risk factors for cardiac disease admitted to hospital due to acute coronary syndrome are described. Two of them had received chest irradiation and chemotherapy for Hodgkin's disease in the past and the third had been treated with chemotherapy for breast cancer. They underwent emergency coronary angiography myocardial revascularisation with success (PCI treatment and CABG). Continued longitudinal screening of patients exposed to radiation and chemotherapy is needed to provide the best cardiology care.
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PMID:[Radiotherapy and chemotherapy for oncological diseases--unappreciated risk factors for coronary artery disease? Acute coronary syndrome in 3 women after radiotherapy and chemotherapy--case reports]. 1847 70

Previous studies have shown increased cardiovascular mortality as late side effects in Hodgkin lymphoma (HL) patients. This study identifies stratifying risk factors for surveillance and defines concepts for a clinical feasible and noninvasive prospective protocol for intervention of cardiovascular side effects. HL patients diagnosed between 1965 and 1995 (n = 6.946) and their first-degree relatives (FDR) were identified through the Swedish Cancer Registry and the Swedish Multigeneration Registry. For the HL and FDR cohort, in-patient care for cardiovascular disease (CVD) was registered through the Hospital Discharge Registry, Sweden. Standard incidence ratios of developing CVD for the HL cohort were calculated. A markedly increased risk for in-patient care of CVD was observed in HL patients with HL diagnosed at age 40 years or younger and with more than 10 years follow-up. In the HL survivors, a family history of congestive heart failure (CHF) and coronary artery disease (CAD) increased the risk for these diseases. The Swedish Hodgkin Intervention and Prevention study started in 2007. In the pilot feasibility study for prospective intervention (47 patients), about 25% of the cases had side effects and laboratory abnormalities. These patients were referred to a cardiologist or general practitioner. In the prospective cohort, a positive family history for CHF or CAD could be a stratifying risk factor when setting up a surveillance model. The prospective on-going study presents an intervention model that screens and treats for comorbidity factors. This article also presents an overview of the study concept.
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PMID:Long-term risk of cardiovascular disease in Hodgkin lymphoma survivors--retrospective cohort analyses and a concept for prospective intervention. 1916 57

Mediastinal irradiation for cancers, mainly breast cancer and Hodgkin's disease, has numerous potential adverse effects, including coronary artery disease, pericarditis, cardiomyopathy, valvular disease, and conduction abnormalities. The prevalence of valvular dysfunction is relatively low, and regurgitation is more common. We report the case of a 58-year-old woman with severe radiation-induced mitral stenosis and discuss the potential additional value of three-dimensional transesophageal echocardiography.
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PMID:Radiotherapy-induced mitral stenosis: a three-dimensional perspective. 1976 51

During the next decade, a rapid increase in the number of new cancer diagnoses in the population as well as a growing number of cancer survivors can be expected. Cancer is anticipated to exceed cardiovascular disease as the primary cause of mortality in the United States population. Despite efforts in tobacco control, the aging of the population and obesity epidemic will contribute toward the increasing incidence of cancer. Although oncology specialists will continue to play a critical role in the diagnosis and initial treatment of patients with cancer, primary care providers will need to play an expanding role in the early detection of cancer, as well as the follow-up, health promotion, and cancer surveillance that will be necessary after initial cancer treatment. Oncology specialists will need to do a better job coordinating the care of their patients with primary care providers, and work toward a shared care model that will optimize the quality of care delivered by the health care system. Cancer treatment summaries and survivorship care plans are an initial attempt to address the current fragmentation and lack of coordination in care that exist today. Cancer survivors are at risk for a wide range of late effects after their primary cancer treatment. Unfortunately, there is limited information about the exact incidence and prevalence of many physical late effects. For example, how many women given standard adjuvant chemotherapy with doxorubicin and cyclophosphamide for breast cancer at age 35 years will develop permanent amenorrhea after treatment, and be infertile? What is the excess risk of osteoporosis in a 70-year-old man receiving endocrine therapy for prostate cancer? What is the risk of coronary artery disease after mantle irradiation for Hodgkin lymphoma? Because of the limited database for many of these sequelae of treatment, clinicians have to keep all of these potential risks in mind as they interview a survivor, and develop a long-term management plan that focuses on symptomatic management and future chronic disease prevention. Until one has a better sense of the natural history of these late sequelae, as well as better information about who is at risk, focusing on a taking a cancer survivor-directed medical history may be the best detection tool that is available. Drawing on a shared care model, primary care providers should collaborate with oncology specialists to determine if cancer-specific laboratory and radiographic studies are indicated to determine if the patient has a cancer treatment-related late effect or cancer recurrence. Health promotion and aggressive management of comorbid conditions should be a standard of care for cancer survivors, as with other patients in the primary care practice. With the growing number of cancer survivors, as well as the recommendations of the IOM report directing research and policy on this subject (see Box 1), it is hoped that in the future a better evidence base to direct health care management in cancer survivors will be built up.
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PMID:Survivorship: adult cancer survivors. 1991 84

Long-term survival in Hodgkin lymphoma (HL) survivors is complicated by an increased risk for coronary artery disease (CAD) due to radiation-induced endothelial damage. Our objective was to quantify total coronary artery calcium (CAC) in long-term HL survivors who had survived >or=15 years after treatment and relate it to the presence of verified CAD. Forty-seven HL survivors 50 +/- 7 years of age who had survived 22 +/- 3 years after mediastinal radiotherapy underwent CAC scoring (Agatston and volume scores) in a multidetector computed tomographic scanner. Total volume score was higher in 7 patients (15%) with verified CAD (median 439, range 8 to 2,057) compared to those without (median 68, 0 to 767, p = 0.022). Ten patients had CAC scores >200. Of these 10, 5 had undergone revascularization of coronary arteries. None of the 8 patients with a CAC score 0 had symptomatic CAD. In conclusion, postirradiation CAC can be quantified by CAC score and this may be a simple and suitable method to screen for CAD in long-term HL survivors. Patients with a CAC score >200 often have clinically significant CAD, and further investigation including angiography may be justified. Lower CAC scores, however, do not exclude CAD and further studies should be undertaken to define the best algorithm for follow-up of this patient group.
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PMID:Relation of coronary artery calcium score to premature coronary artery disease in survivors >15 years of Hodgkin's lymphoma. 2010 9


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