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Radiation induced valvular disease: the internist’s prospective
  1. Sundeep Kumar1,2,
  2. Hiren Patel1,
  3. Joyce Paulson1 and
  4. Bernard Gros1
  1. 1 Department of Internal Medicine, University of Central Florida College of Medicine, orlando, Florida, USA
  2. 2 Department of Internal Medicine, Orlando VA Medical Center, Orlando, Florida, USA
  1. Correspondence to Dr Sundeep Kumar, drkumar.sundeep{at}


Radiation-induced cardiac injury entails a wide spectrum of cardiovascular complications such as cardiomyopathy and valvular diseases among others. We present the internist’s perspective and the challenges faced in managing these patients. There are guidelines addressing radiation-induced valvular disease (RIVD) including screening and treatment, but are often unrecognised by most internist’s practice. A thorough cardiovascular examination and screening echocardiography may detect RIVD at an earlier stage. Early screening with transthoracic echocardiogram should be considered in asymptomatic or low-risk patients and more frequently in symptomatic and high-risk patients. The internists should educate their patients with prior chest irradiation, regarding the possible radiation related adverse cardiovascular effects and recommended screening. Lifestyle changes and aggressive cardiovascular risk modification should be emphasised, as concomitant hypertension, coronary artery disease and cardiomyopathy can have unfavourable effects in these patients.

  • valvar diseases
  • radiology
  • unwanted effects / adverse reactions
  • radiotherapy

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  • Patient consent for publication Obtained.

  • Contributors SK provided the conception of the manuscript and contributed to drafting the manuscript.Dr. HP contributed to the conception of manuscript, literature search and drafting the case. JP contributed to review of data, conception of manuscript and provided the patient care. BG contributed to critical revision and drafting of manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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