[Anterior wall infarct in an 18-year-old patient with Hodgkin's disease. Possible relation between mediastinal irradiation, accelerated arteriosclerosis and vincristine chemotherapy].

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.