Radiation induced cardiac valve disease in a man from Chernobyl.

A young man presented with a new heart murmur. History revealed that the patient was from Ukraine, which was affected by the Chernobyl nuclear plant explosion in 1986. Physical examination revealed murmurs of mitral regurgitation and aortic stenosis. Transesophageal echocardiography revealed severely calcified mitral and calcified tricuspid aortic valves with mitral and aortic regurgitation and aortic stenosis. Following valve replacement surgery, pathologic examination of the valves showed severe dystrophic calcifications and changes suggestive of a chronic inflammatory process such as radiation-induced valve disease. In the absence of another etiology explaining such severe valve disease in a young man, it can only be surmised that heavy radiation exposure from the nuclear plant caused this significant valve damage.