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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 26-year-old man received extensive cardiac radiation in the course of treatment of mediastinal Hodgkin's disease, and six years later, he experienced an acute myocardial infarction. Angiographic studies demonstrated extensive atherosclerotic abnormalities in the coronary arterial system. It is suggested that radiation-induced injury was a provocation of these precocious arterial abnormalities.
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PMID:Precocious myocardial infarction after radiation treatment for Hodgkin's disease. 97 92

Pericardial effusion and trifascicular block developed 5 years following mediastinal irradiation for Hodgkin's disease in a 19-year-old patient. Another 24-year-old patients had an acute myocardial infarction followed by severe angina pectoris 5 years following mediastinal irradiation for the same disease. A pericardial window and a permanent demand pacemaker were used in the first case; an aorto-coronary vein grafting was utilized in the second patient. Both patients responded to treatment and are well. Five other previously reported cases of myocardial injury that occurred 2 months to 8 years following mediastinal irradiation in young patients were reviewed. To our knowledge, successful surgical treatment of this disease entity has not been reported before. Close, long-term follow-up of patients who have received mediastinal irradiation should be helpful in the early recognition and successful management of these serious cardiac complications. The systematic clinical and radiographic surveilance of these patients should be supplemented by a routine 12-lead electrocardiogram.
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PMID:Radiation-related myocardial injury. Management of two cases. 108 10

Attention is called to the development of coronary heart disease in two patients several years after they received mediastinal irradiation for Hodgkin's disease. One patient, a 33 year old man, died suddenly eight years after irradiation; necropsy disclosed marked narrowing of all three major coronary arteries. In addition to severe intima fibrous thickening, there also was considerable adventitial scarring of the coronary arteries. This type of coronary sclerosis is different from that seen in the usual patient with coronary heart disease. The second patient, a 42 year old man, had an acute myocardial infarction on two occasions, the first six years after mediastinal irradiation. Observations in previously described patients with coronary heart disease almost surely induced by therapeutic irradiation for Hodgkin's disease are reviewed.
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PMID:Coronary heart disease after mediastinal irradiation for Hodgkin's disease. 125 45

The authors conducted a follow-up study of the association between mediastinal irradiation, chemotherapy, and mortality from coronary artery disease in 4665 patients treated for Hodgkin's disease. Study subjects were followed after the diagnosis of Hodgkin's disease until death or the closing date of the study. The average duration of follow-up was 7 years; 2415 patients died, and 124 cases of coronary artery disease were identified from death certificates, including 68 cases of acute myocardial infarction. The age-adjusted relative risks (RR) of death with any coronary artery disease after mediastinal irradiation and after chemotherapy were 1.87 (95% confidence interval [CI], 0.92 to 3.80) and 1.28 (CI, 0.77 to 2.15), respectively. A significantly increased risk of death in the subcategory myocardial infarction was observed after mediastinal irradiation (RR, 2.56; CI, 1.11 to 5.93) but not after chemotherapy (RR, 0.97; CI, 0.53 to 1.77). These results support the hypothesis that radiation therapy to the mediastinum increases the risk of coronary artery disease.
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PMID:Coronary artery disease mortality in patients treated for Hodgkin's disease. 173 22

A 32-year-old man with Hodgkin's disease presented an acute myocardial infarction following mediastinal irradiation. A complete occlusion at the level of the proximal segment of the right coronary artery and a moderate stenosis of the left circumflex coronary artery was demonstrated by selective coronary angiography. An inferior hypokinesia was seen by the ventricular angiography. We discuss the possible role of the mediastinal irradiation in the induction of coronary heart disease as well as the importance of an early diagnosis.
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PMID:[Coronary disease after the radiotherapy of the mediastinum in Hodgkin's disease]. 192 23

Forty-seven patients younger than 40 years at the time of the diagnosis, and irradiated to the mediastinum for Hodgkin's disease at Turku University Central Hospital from 1977 to 1982, were regularly followed for 56 to 127 months after therapy. Two patients developed an acute myocardial infarction ten and 50 months after cardiac irradiation at the age of only 28 and 24 years, respectively. None of the patients died from lymphoma within five years from the diagnosis, but one of the infarctions was eventually fatal. Since acute myocardial infarction is rare in this age group, the result suggests strongly that prior cardiac irradiation is a risk factor for acute myocardial infarction. The possibility of radiation-induced myocardial infarction should be taken into account both in treatment planning and follow-up of patients with Hodgkin's disease.
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PMID:Acute myocardial infarction after heart irradiation in young patients with Hodgkin's disease. 291 91

Fifteen patients with lymphoid malignancies and tumour-related fever (greater than 38.0 degrees C) were given 50 mg indomethacin (IM) orally. This resulted in a reduction of body temperature in all cases (mean +/- SD 3.4 +/- 2.0 degrees C). In one patient with untreated Hodgkin's disease, temperature fell from 40.6 degrees C to 30.6 degrees C within 12 hours without any cardiovascular or respiratory distress. The lytic effect of IM on fever was more pronounced and more rapid in the 15 patients with lymphoma than in a group of 10 patients with acute myocardial infarction. IM therapy has a clear value in relieving tumour-associated fever in patients with malignant lymphoma. There may be a qualitative difference between the IM response of tumour-related fever and fever related to non-malignant diseases.
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PMID:Antipyretic effect of indomethacin in malignant lymphoma. 348 41

Twenty-eight patients younger than age 40 years, treated for Hodgkin's disease with mediastinal irradiation, were examined no less than 5 years after the irradiation in order to evaluate the frequency of cardiac abnormalities. Twelve patients (43%) had had some pericardial event after radiation: a diagnosed pericarditis, remarkably increased heart volume, or a conspicuous change of cardiac silhouette, suggesting pericardial fluid. On evaluation, 50% of the patients complained of symptoms, and 13 patients had to stop the exercise test on a low level because of chest pain, dyspnea, or general fatigue. In 13 patients some of the following abnormalities in the electrocardiogram (ECG) was found: right bundle branch block (four), first-degree atrioventricular block (four), abnormal P terminal force (five), or a low voltage (two). In ten patients (38%) an increase of the pericardial fluid was seen in the echocardiogram, and in nine patients the right ventricle wall thickness had increased. In two patients a severe coronary artery disease was found. One died suddenly after an acute myocardial infarction (AMI), and the other had a large anterior AMI. Two patients with chronic pericardial fluid underwent partial pericardectomy. Two cases of mild pulmonary valve stenosis, one pulmonary subvalvular stenosis and two aortic valve deformities were discovered. Eight patients went through cardiac catheterization, and in all but one case the pressures were slightly elevated suggesting diminished diastolic compliance. In summary, 19 of 28 patients had some abnormal cardiac findings, but only three of them were serious ones.
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PMID:Late cardiac effects of mediastinal radiotherapy in patients with Hodgkin's disease. 358 Oct 32

An 18-year-old male patient with Hodgkin's disease, having undergone radiotherapy to the mediastinum two-and-a-half years previously, developed symptoms of an acute myocardial infarction within three hours of a vincristine injection (the first course of vincristine chemotherapy had been finished eight days previously). Invasive investigation after three weeks revealed single-vessel occlusion of the anterior interventricular branch with an anterior-wall aneurysm. The most likely cause of the coronary heart disease in this patient is changes in the anterior interventricular branch resulting from the mediastinal radiotherapy. The infarct itself occurred in close temporal relationship to the vincristine injection, which in several case reports has been implicated in the triggering of coronary spasms.
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PMID:[Anterior wall infarct in an 18-year-old patient with Hodgkin's disease. Possible relation between mediastinal irradiation, accelerated arteriosclerosis and vincristine chemotherapy]. 360 47

Coronary artery disease (CAD) developed in 15 patients at a mean of 16 years (range 3 to 29) after chest irradiation. The mean dose of radiation was 42 +/- 7 grays; irradiation was performed for Hodgkin's disease in 9 patients, lymphoma in 2, breast carcinoma in 3 and cystic hygroma in 1 patient. Mean age was 48 years (range 26 to 63) at diagnosis of CAD; 4 patients were younger than 35 years. Nine were women. Ten presented with angina, 3 with acute myocardial infarction, 1 patient with syncope and 1 with dyspnea. Twelve had no more than 2 risk factors of atherosclerosis. At coronary angiography, 8 had at least 50% diameter narrowing of the left main coronary artery and 4 had severe ostial stenosis of the right coronary artery. Eight patients also had valvular heart disease, 4 pericardial disease and 4 complete heart block. Mean left ventricular ejection fraction was 67 +/- 11% (range 53 to 80%). Nine had undergone coronary artery bypass grafting, but surgery was difficult or impossible in 3 because of severe mediastinal and pericardial fibrosis. Radiation-associated CAD is characterized by a high incidence of left main and right ostial coronary disease and often occurs in women with relatively few conventional risk factors for CAD.
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PMID:Clinical and angiographic features of coronary artery disease after chest irradiation. 367 2


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