Cozzarín Alberto, Cianciulli Tomás F, Saccheri María C, Lax Jorge A, Simonetti Mario E, Zappi Andrea, Laguens Rubén P
Department of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich", Buenos Aires, Argentina.
Echocardiography. 2014 Feb;31(2):E37-40. doi: 10.1111/echo.12409. Epub 2013 Oct 21.
We present the case of a 69-year-old patient with a history of gynecological neoplasia and a pulmonary metastasis, who in 1996 underwent chemotherapy and mediastinal radiotherapy followed by cancer remission. Ten years later she presented with heart failure and her Doppler echocardiogram showed severe mitral regurgitation with pulmonary hypertension. In 2011, she underwent a mitral valve replacement with a biological prosthesis and the pathology exam revealed valve damage consistent with radiotherapy-induced changes. This unusual mechanism of mitral regurgitation can be demonstrated clearly by echocardiography and should be disseminated among cardiology physicians and in patients who have survived for long periods after radiotherapy, it is important to remember that cardiac complications may indeed occur, and the treating physician is responsible for detecting them.
我们报告了一例69岁的患者，有妇科肿瘤病史并伴有肺转移，该患者于1996年接受了化疗和纵隔放疗，随后癌症缓解。十年后，她出现心力衰竭，多普勒超声心动图显示严重二尖瓣反流伴肺动脉高压。2011年，她接受了生物瓣膜二尖瓣置换术，病理检查显示瓣膜损伤与放疗引起的改变一致。这种不寻常的二尖瓣反流机制可通过超声心动图清楚显示，应在心脏病医生中进行宣传，对于放疗后长期存活的患者，重要的是要记住心脏并发症确实可能发生，治疗医生有责任检测到它们。
