Sharifkazemi Mohammadbagher, Elahi Mahsa, Sayad Masoud
Department of Cardiology, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Radiation Oncology Department, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Front Cardiovasc Med. 2023 Apr 19;10:1020082. doi: 10.3389/fcvm.2023.1020082. eCollection 2023.
Breast cancer is the most commonly diagnosed cancer in women worldwide, and with the increased survival of patients by novel treatments, the frequency of complications of cancer treatments rises. Radiotherapy, especially on the chest wall, can damage different cardiac structures. Radiotherapy-induced cardiomyopathy mainly occurs over 10 years after breast cancer treatment; however, there is a gap in the literature on acute myocarditis following radiotherapy. Here, we present a 54-year-old woman who developed acute myocarditis shortly after 25 sessions of radiotherapy with 50 Gy of radiation, successfully diagnosed with the use of speckle tracking echocardiography (STE) and cardiac magnetic resonance (CMR), and responded to the medical treatment with relative clinical improvement until the final follow-up. This case suggests the necessity of detailed examination of patients after radiotherapy, not only for chronic occurrence of cardiomyopathy but also for acute myocarditis. Although STE and CMR resulted in accurate diagnosis, in this case, further studies are required to determine the diagnostic accuracy of these two imaging methods compared with other imaging modalities in such patients and investigate the best diagnostic tool and therapeutic approach for these patients.
乳腺癌是全球女性中最常被诊断出的癌症,随着新型治疗方法提高了患者的生存率,癌症治疗并发症的发生率也在上升。放射治疗,尤其是对胸壁的放疗,会损害不同的心脏结构。放疗诱发的心肌病主要发生在乳腺癌治疗后10年以上;然而,关于放疗后急性心肌炎的文献存在空白。在此,我们报告一名54岁女性,在接受25次共50 Gy的放疗后不久发生急性心肌炎,通过斑点追踪超声心动图(STE)和心脏磁共振成像(CMR)成功诊断,并在最终随访前药物治疗有效,临床症状相对改善。该病例提示放疗后不仅要对患者进行详细检查以监测慢性心肌病的发生,还要关注急性心肌炎。虽然STE和CMR实现了准确诊断,但在此病例中,还需要进一步研究以确定这两种成像方法与其他成像方式相比对此类患者的诊断准确性,并探究针对这些患者的最佳诊断工具和治疗方法。