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.