Severe Mitral Regurgitation after Radiotherapy

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 31; no. 2; pp. E37 - E40
• Main Authors: Cozzarín, Alberto, Cianciulli, Tomás F., Saccheri, María C., Lax, Jorge A., Simonetti, Mario E., Zappi, Andrea, Laguens, Rubén P.
• Format: Journal Article
• Language: English
• Published: United States 01-02-2014
• Subjects: Aged; echocardiography; Echocardiography - methods; Female; Heart Failure - diagnostic imaging; Heart Failure - etiology; Heart Failure - surgery; Humans; Mitral Valve Insufficiency - diagnostic imaging; Mitral Valve Insufficiency - etiology; Mitral Valve Insufficiency - surgery; Organs at Risk - radiation effects; Organs at Risk - surgery; Radiation Injuries - diagnostic imaging; Radiation Injuries - etiology; Radiation Injuries - surgery; radiotherapy; Radiotherapy - adverse effects; severe mitral regurgitation; Treatment Outcome; radiotherapy; severe mitral regurgitation; echocardiography
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/echo.12409

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.
Mini‐
We present the case of a 69‐year‐old patient with a history of gynecological neoplasia and a pulmonary metastasis, who underwent chemotherapy and mediastinal radiotherapy followed by cancer remission. Fifteen years later she presented with heart failure and severe mitral regurgitation with pulmonary hypertension. She underwent a mitral valve replacement 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 in patients who have survived for long periods after radiotherapy, it is important to remember that cardiac complications may indeed occur.