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

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.
Am J Cardiol 1987 Nov 01
PMID:Clinical and angiographic features of coronary artery disease after chest irradiation. 367 2

This report describes three patients who developed myocardial infarction at an untimely age, 4 to 12 years after radiation therapy for Hodgkin's disease. These cases lend credence to the cause and effect relation of such therapy to coronary artery disease.
J Am Coll Cardiol 1986 Jul
PMID:Radiation-induced coronary artery disease. 371 22

An 18-year-old woman, affected by Hodgkin's disease and treated successfully with radiotherapy, died suddenly. The postmortem study showed an acute septal myocardial infarction in the presence of a severe focal atherosclerotic lesion of the anterior descending coronary artery. This suggests that radiation may contribute to the early development of coronary artery disease.
Int J Cardiol 1985 Nov
PMID:Radiation-induced coronary obstructive atherosclerosis and sudden death in a teenager. 405 53

Radiotherapy is an effective tool in the treatment of thoracic cancers. However, radiotherapy also carries a risk of severe cardiac complications. The cancers most commonly concerned are Hodgkin's and non-Hodgkin's lymphomas (90 per cent of cases), breast cancers, especially on the left side (4 per cent) and bronchogenic cancers (2 per cent). Ionizing radiation can damage the three layers of the heart and the coronary arteries. Pericardial involvement is the most frequent, occurring in 10 to 12 per cent of cases. It generally occurs 6 to 18 months after the radiotherapy and may present either acutely (35 per cent of cases) or chronically (65 per cent of cases). It is often latent, only detected on X-rays or on ultrasound. Constrictive forms can occur, which require pericardiectomy. Myocardial fibrosis, which is anatomically common, may present as disturbances of repolarization, arrhythmia or disturbances of conduction, or even cardiac failure. Rarely, radiation damage of the coronary arteries can cause angina or myocardial infarction. These cases can benefit from coronary artery by-pass grafts. All of these lesions have a common anatomical denominator:fibrosis, which develops progressively following the radiotherapy. It has now been demonstrated that the incidence of cardiac radiation lesions can be reduced by homogeneous distribution of the dose of radiation administered to the mediastinum, by treating each side alternately, by fractionating the radiation and staggering the sessions and by reducing the cardiac mass which is irradiated.
Ann Cardiol Angeiol (Paris) 1983 Nov
PMID:[Cardiac complications of radiotherapy]. 666 Aug 23

Occult or overt but delayed cardiac disease after thoracic radiotherapy for Hodgkin's disease may be common. Detailed cardiac evaluations were performed in 48 patients with Hodgkin's disease at risk a mean of 97 months after radiotherapy. The study protocol included echocardiography, gated radionuclide ventriculography, and cardiac catheterization. Cardiac disease was found in 46 patients (96%) and included constrictive or occult constrictive pericarditis (24 patients), an abnormal hemodynamic response to a fluid challenge (14 patients), coronary artery disease (6 patients), and left ventricular dysfunction (2 patients). Most patients (53%) had normal echocardiograms. Gated blood pool radionuclide angiocardiography was performed in 42 patients. Excluding patients with occlusive coronary artery disease, the left ventricular ejection fraction at rest (mean 59%) and during exercise (mean 69%) was within normal limits. Congestive heart failure occurred in 2 patients. Six patients had pericardiectomy for constrictive pericarditis and 3 patients had coronary artery bypass surgery for coronary artery disease. Thus (1) delayed cardiac disease after radiotherapy is common, (2) chronic pericardial disorders are the most frequent manifestations of this disease, and (3) the prognosis for patients who have radiation-induced cardiac disease is generally favorable.
Am J Cardiol 1983 Jun
PMID:Cardiac disease after radiation therapy for Hodgkin's disease: analysis of 48 patients. 685 75

The cardiac slow inward current (Isi) is mediated by a specific conductance system, the slow channel. It is highly selective for Ca and other bivalent cations as for instance Sr, whilst Na permeability is extremely small. The kinetics of activation, inactivation and recovery from inactivation are voltage- and temperature-sensitive. In contrasts to the Hodgkin-Huxley model, development and removal of inactivation operate with different time constants, at least in the ventricular myocardium of cats. Moreover, both processes exhibit a different pharmacological susceptibility. Thus a second inactivation variable having smaller rate constants than the inactivation variable if has to be introduced, which simultaneously suggests the existence of slow inactivation in cardiac slow channels.
Basic Res Cardiol
PMID:Slow channel kinetics in heart muscle. 733 14

We describe the case of a patient (pt) treated with radiotherapy for Hodgkin's lymphoma at the age of 17. Two years later he presented an apical AMI and underwent coronary angiography (CA) for postinfarction angina. A 40% stenosis of the left anterior descending (LAD) was found in the proximal portion and the vessel was occluded at the middle level. Septal and diagonal branches supplied collaterals to the distal LAD and left ventricular function was only mildly reduced (EF angio-ventriculographic = 52%). We successfully performed a first PTCA, but the pt was re-admitted to our hospital few days later for a new large anterior myocardial infarction with refractory hypotension and low output condition. An intraaortic balloon catheter was inserted and CA demonstrated proximal LAD occlusion; a new PTCA was then performed and the opening of the vessel was obtained after 90' from symptoms' onset. The subsequent course was uneventful and the pt was discharged after 20 days. The ejection fraction was 39%. Thirty days after, a third PTCA with Palmaz-Schatz stent implantation was necessary for unstable angina due to a restenosis of the proximal LAD. After ten months follow-up the pt is asymptomatic with negative exercise test and an angioscintigraphic EF = 47%. CA and intravascular ultrasound demonstrated nor restenosis or progression of the disease, with a good minimal luminal diameter (MLD). A review of the literature on this topic is presented. Moreover we discuss the mechanism of coronary stenosis and occlusion and the reasons for choosing PTCA in the various settings.
G Ital Cardiol 1995 Jul
PMID:[A case of radiation-induced coronary occlusion treated with elective and emergency PTCA]. 755 36

Occult or overt but delayed cardiac disease after thoracic radiotherapy for Hodgkin's disease may be common. Detailed cardiac evaluation was performed in 108 patients, mean age 46 +/- 6.2 years, with Hodgkin's disease at 175 +/- 43 months after irradiation. The study protocol included clinical examination, graded treadmill exercise test and echocardiography. Some patients with angina pectoris, previous myocardial infarction and an abnormal ECG were studied by thallium-201 scintigraphy, cardiac catheterization and coronary angiography. Cardiac disease was found in 12 patients (11%). Three patients had angina pectoris, one patient had myocardial infarction, two complained of dyspnea on effort and two had congestive heart failure. At catheterization, constrictive pericarditis was diagnosed in four patients; in two additional patients an occult constrictive pericarditis was found. One patient had both mitral and tricuspidal regurgitation and one had mitral regurgitation alone. Eight patients (7.4%) had severe coronary artery disease; four of these had associated constrictive pericarditis. Four patients had a pericardiectomy and another four had undergone coronary artery by-pass graft. Two patients died after operation from persistent pericardial constriction. It is concluded that the incidence of delayed cardiac disease after radiotherapy is relatively high; chronic pericardial disorders and coronary artery disease are the most frequent manifestations of this disease. Standard surgical treatment may be beneficial because of the relative youth of these patients.
Int J Cardiol 1995 Mar 24
PMID:Cardiac disease after chest irradiation for Hodgkin's disease: incidence in 108 patients with long follow-up. 760 65

A 71 years old man, ex-smoker, moderate drinker, with a history of diabetes mellitus (type II), moderate arterial hypertension, mild aortic stenosis and moderate uniform left ventricular hypertrophy echographically documented, developed a non Hodgkin low malignancy cavum lymphoma. He has underwent chemotherapy for two years (adriamycin and other chemotherapy drugs) at moderate dosages. A complete remission of the lymphoma followed the treatment, but an initial deterioration of left ventricular function, with heart dilatation and congestive heart failure, was found. The patient improved by medical treatment, returning to the previously stable clinical condition. However a ventricular dilatation reoccurred and a paroxysmal complete atrio-ventricular block developed, necessitating the implantation of a pace maker. The patient died suddenly, during sleep, at home. This is a unique case, because of the numerous cardiac factors associated (chemotherapy and clinical findings). More probably the combination of these multiple factors and their interrelationship could explain the unique non-linear evolution of the left ventricular hypertrophy. In conclusion in these patients a very strict clinical and pharmacological follow up with serial echocardiographical examinations is fundamental and highly recommended.
G Ital Cardiol 1994 Jul
PMID:[Normalization of left ventricular function and subsequent recurrence of dilatation and pump failure in a patient with hypertensive heart disease in dilated phase after treatment with anthracycline]. 792 84

We investigated the clinical, electrophysiological, haemodynamic and angiographic aspects of four patients (two men and two women, aged 31-46 years) who developed complete heart block 13-20 years after therapeutic irradiation of the chest for Hodgkin's disease. The initial cardiac symptom was syncope in three, effort intolerance in one. The electrocardiogram recorded third-degree atrioventricular block in three patients, right bundle branch block and posterior fascicular block in one. The electrophysiological study, performed in three cases, showed that the block was infranodal in two. Three patients had significant coronary arterial stenoses, that involved the ostia in two. All patients had mild-to-moderate aortic and mitral regurgitation. One patient had haemodynamic signs of constriction. Another patient had recurrent pericardial effusions. All had echocardiographic evidence of a thickened pericardium. Cardiac involvement can be extensive in patient with radiation-induced heart block. Because coronary artery disease can be particularly severe, coronary angiography appears to be warranted in such patients.
Int J Cardiol 1993 May
PMID:Associated cardiac lesions in patients with radiation-induced complete heart block. 831 49


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