Early-Onset Bilateral Severe Valvular Regurgitation After Mediastinal Radiotherapy in Hodgkin Lymphoma Survivors: Should We Screen Prior to 10 Years After Mediastinal Radiotherapy?

Background: Radiation-induced valvulopathy (RIV) is a common complication of mediastinal radiotherapy and usually occurs at least 10 years after exposure to radiotherapy. Case Report: We report the case of a 37-year-old female with a history of stage IIIB Hodgkin lymphoma who was diagnosed with RIV after all other potential causes of shortness of breath and valvular dysfunction were excluded. The patient's presentation, 6 years after receiving chemotherapy and radiotherapy for Hodgkin lymphoma, was earlier than expected after mediastinal radiotherapy. The patient was started on a regimen of lisinopril, nifedipine, and metoprolol, and her symptoms improved significantly within 4 days of starting medical therapy. We review the literature, discuss the risk factors and determinants of developing RIV, and suggest the ideal timing to screen patients. Conclusion: This case is of educational value for internal medicine, oncology, and cardiology healthcare providers who should consider RIV as a cause of shortness of breath in patients who underwent mediastinal radiotherapy for Hodgkin lymphoma.