Báez-Ferrer Néstor, Izquierdo-Gómez María Manuela, Beyello-Belkasem Carima, Jorge-Pérez Pablo, García-González Martín J, Ferrer-Hita Julio J, De la Rosa-Hernández Alejandro, García-Niebla Javier, Lacalzada-Almeida Juan
Department of Cardiology, University Hospital of the Canary Islands, Tenerife, Spain.
Am J Case Rep. 2019 Aug 11;20:1182-1188. doi: 10.12659/AJCR.917224.
BACKGROUND Tumor disease has improved survival due to therapeutic advances and early diagnosis. However, anti-neoplastic treatment involves generating harmful side effects in the body, both in the short-term and in the long-term. One of the most important side effects is cardiovascular disease after radiotherapy, which in addition to being influenced by classic cardiovascular risk factors, can be also be influenced by anti-neoplastic therapy, and represents the main cause of death after a second cancer. We present a case that synthesizes the most relevant and determining aspects of radiotherapy-induced heart disease. CASE REPORT We present the case of a 48-year-old male with a personal history of mediastinal Hodgkin lymphoma who was treated with local radiotherapy 20 years ago, and who was admitted to hospital due to dyspnea and oppressive chest pain with efforts. He was diagnosed with severe aortic stenosis, and a coronary angiography confirmed the existence of coronary disease. Two years before, he had been admitted to hospital due to syncope and a pacemaker had been implanted. This patient experienced several cardiovascular complications that could be attributed to the radiotherapy treatment received in his past. CONCLUSIONS Radiotherapy shows multiple cardiological complications, especially when applied at the thoracic level. This fact is very relevant, and this report can help determine the aspects of radiotherapy-induced heart disease affecting the mortality and morbidity of these patients.
背景 由于治疗进展和早期诊断，肿瘤疾病患者的生存率有所提高。然而，抗肿瘤治疗会在短期内和长期内对身体产生有害副作用。最重要的副作用之一是放疗后发生的心血管疾病，它除了受经典心血管危险因素影响外，还可能受抗肿瘤治疗的影响，并且是二次癌症后主要的死亡原因。我们报告一例综合了放疗诱发心脏病最相关和决定性因素的病例。病例报告 我们报告一例48岁男性，有纵隔霍奇金淋巴瘤个人史，20年前接受局部放疗，因劳力性呼吸困难和压榨性胸痛入院。他被诊断为严重主动脉瓣狭窄，冠状动脉造影证实存在冠心病。两年前，他因晕厥入院并植入了起搏器。该患者经历了多种心血管并发症，可归因于他过去接受的放疗治疗。结论 放疗显示出多种心脏并发症，尤其是在胸部进行放疗时。这一事实非常重要，本报告有助于确定影响这些患者死亡率和发病率的放疗诱发心脏病的相关因素。
