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Cardio-Oncologists Perspective on the Cardiac Implications of Radiotherapy: Complex Cases of Radiation-Related Valvular and Vascular Disease

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Atlas of Imaging in Cardio-Oncology

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Abstract

Chest radiation therapy (RT) is an important cause of cardiovascular disease in patients treated for cancers including lung, esophagus, mediastinal tumors, and especially Hodgkin disease and breast cancer.

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Authors and Affiliations

  1. Department of Cardiology, Functional and Ultrasound Diagnostics, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

    Maria Poltavskaya

Authors
  1. Maria Poltavskaya
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Correspondence to Maria Poltavskaya .

Editor information

Editors and Affiliations

  1. Department of Medicine, Cardiology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Richard M. Steingart

  2. Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jennifer E. Liu

23.1 Electronic supplementary material

Below is the link to the electronic supplementary material.

Video 23.1

Echocardiography in 2016 before TAVR. A, Parasternal long axis view showing calcification and thickening of aortic valve cusps (arrow) with severe limitation of their opening. Aortic valve annulus is also calcified. We can see also that LV contractility is low. LV—left ventricle. TAVR—transcatheter aortic valve replacement. B, Short axis view of aortic valve showing markedly limited excursion and calcification of the cusps (PPTX 1953 kb)

Video 23.2

Echocardiography in 2016 before TAVR. A, Moderate aortic regurgitation. B, LV hypokinesis. LVEF estimated at <20%. LV—left ventricle. LVEF—left ventricular ejection fraction TAVR—transcatheter aortic valve replacement (PPTX 1545 kb)

Video 23.3

Coronary angiography. Intact LAD and LCx with late collateral contrast filling of obstructed RCA. LAD—left anterior descending artery. LCx—left circumflex artery. RCA—right coronary artery (PPTX 6842 kb)

Video 23.4

Coronary angiography of left coronary artery at first presentation in 2009. A and B, Two views before stenting showing significant LCx stenosis. C and D, After stent placement in LCx showing good coronary flow. LCx—left circumflex artery (PPTX 4597 kb)

Video 23.5

Left panel: Angiography of the left subclavian artery performed after the onset of arm claudication in 2010 showing severe arterial stenosis. There are no visible branches of the artery due to the markedly reduced blood flow. Right panel: Angiography of the left subclavian artery after stenting. There is normal contrast filling of the subclavian artery and its branches (PPTX 1300 kb)

Video 23.6

Coronary angiography performed in May 2019 when the patient was admitted with worsening heart failure and some chest discomfort not typical for angina (unlike the first presentation in 2009). It shows stenoses at the proximal and the distal ends of the stent in LCx. LAD appears normal. LAD—left anterior descending artery. LCx—left circumflex artery (PPTX 2276 kb)

Video 23.7

Coronary angiography performed in May 2020 at admission with diagnosis of non-ST-elevation myocardial infarction presenting with worsening of heart failure. Shows 2 views of left coronary artery branches revealing subtotal LCx stent stenosis. LAD ostial stenosis was also recognized but it cannot be seen well on these videos. LAD—left anterior descending artery. LCx—left circumflex artery (PPTX 4246 kb)

Video 23.8

Echocardiography after recent coronary intervention in August 2020. A and B, Parasternal long axis view and four-chamber view showing mitral valve with thickening of anterior cusp, shortening of posterior cusp, and calcifications in subvalvular apparatus. Limited opening of mitral valve can be seen also, but mitral stenosis was not confirmed. C, Color Doppler showing high-speed eccentric regurgitant jet at mitral valve. The grade of mitral regurgitation is III (PPTX 1953 kb)

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Poltavskaya, M. (2021). Cardio-Oncologists Perspective on the Cardiac Implications of Radiotherapy: Complex Cases of Radiation-Related Valvular and Vascular Disease. In: Steingart, R.M., Liu, J.E. (eds) Atlas of Imaging in Cardio-Oncology. Springer, Cham. https://doi.org/10.1007/978-3-030-70998-3_23

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  • DOI: https://doi.org/10.1007/978-3-030-70998-3_23

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-70997-6

  • Online ISBN: 978-3-030-70998-3

  • eBook Packages: MedicineMedicine (R0)

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