Late Radiation-Induced Cardiovascular Disease After Childhood Rhabdomyosarcoma: A Case Report

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ID: 320349
2026
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Abstract
Abstract Background Radiation-induced cardiovascular disease may appear decades after cancer therapy and can involve multiple vascular, valvular, myocardial, and conduction structures of the heart. Management is particularly challenging when prior irradiation results in a hostile chest environment and impaired wound healing. Case summary A 31-year-old woman with a history of childhood right forearm rhabdomyosarcoma treated with resection, chemotherapy, and radiotherapy presented with recurrent syncope. Computed tomography angiography revealed asymmetric growth of the right-sided arteries, leading to a transient ischemic attack. Further cardiovascular evaluation revealed multiple concomitant cardiovascular disorders, including valvular heart disease, high-grade atrioventricular block, bradycardia, and heart failure. Permanent pacemaker implantation and right-to-left axillary artery bypass prevented further syncopal episodes; however, heart failure continued to worsen. Two years later, she was hospitalized with severe heart failure and dyspnea, and echocardiography revealed aortomitral continuity calcification and elevated filling pressure. She subsequently underwent the Bentall procedure, tricuspid valve replacement, and coronary artery bypass grafting for advanced coronary stenosis. However, her postoperative course was complicated by pleural effusion and hemoptysis, and she eventually died of multiorgan dysfunction. Discussion This case illustrates the late cardiovascular effects of radiation therapy. Radiation-induced endothelial injury, fibrosis, and maladaptive wound-healing responses may contribute to delayed cardiovascular damage and poor postoperative recovery. In such patients, surgical decision-making should be multidisciplinary, and long-term follow-up is essential.
Reference Key
openalex_W7167830376 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Tuan Hoang Nguyen, Takamitsu Nakamura, Akira Sato
Journal European Heart Journal - Case Reports
Year 2026
DOI
10.1093/ehjcr/ytag488
URL
https://doi.org/10.1093/ehjcr/ytag488
Keywords Keywords not found

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