Late Cardiac Effects of Therapeutic Mediastinal Irradiation

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Abstract
Although the heart was formerly thought to be relatively resistant to radiation,1 the increasing use of radiation therapy to the mediastinum has been associated with well-documented instances of cardiac abnormalities, including pericarditis with effusion and tamponade,2 3 4 5 6 7 coronary-artery fibrosis and myocardial infarction,7 8 9 10 and constrictive pericarditis.6 , 11 Complications occurring within the first 12 to 24 months after treatment are well known2 3 4; nevertheless, the success of radiation in treating malignant conditions — particularly Hodgkin's disease — has led to its use in a sizable number of patients, who may be at risk for cardiac complications many years after therapy. Therefore, we used noninvasive . . .