Treatment Options for Radiation-Associated Heart Disease
It may not be possible to cure radiation-associated heart disease. However, treatments are available that can:
- Reduce symptoms
- Improve quality of life
- Help you live longer
Timing of treatment is important and depends on the individual patient’s symptoms and where they are in their care journey. Together, you and your physician will carefully decide the best timing for treatment.
Below are treatment options for radiation-associated heart disease.
Heart Valve Disease
Radiation can affect the heart muscle itself. However, it is the fibrous tissue of the heart valves that is most often affected.
The aortic and mitral valves become thick. This is called fibrosis, which makes it harder for the valves to open and close. Heart valves that do not open and close properly struggle to move blood through the heart to the body. Over time, calcium may form on the heart valves and in the tissue between the two heart valves.
The fibrosis and calcium make treatment of heart valve disease caused by radiation unique and specialized. Treatment options for heart valves affected by radiation include:
- Transcatheter aortic valve replacement
- Transcatheter mitral valve replacement
- Aortic heart valve replacement surgery
- Mitral heart valve replacement surgery
- Commando heart surgery
Specially-trained Northwestern Medicine heart surgeons offer the Commando heart surgery. This definitive surgery treats both the aortic and mitral valves and the area between the valves affected by calcium formation. During the Commando heart surgery, the team replaces both the aortic and mitral valves and reconstructs the area between the valves.
Cardiomyopathy is a form of heart disease that involves thickening of the heart muscle. The thickened heart muscle is also stiff. This makes it harder for the muscle to relax and fill with blood with each heartbeat.
Treatment options include medication and devices to treat symptoms of heart failure. The care team may consider heart transplantation for some patients.
Coronary Artery Disease
Coronary arteries supply blood to the heart muscle. Over time, after exposure to radiation, the walls of the coronary arteries may become hard and thick, and form calcium deposits. This decreases blood flow through the coronary arteries, resulting in less oxygen for the heart muscle.
The heart is protected by a small amount of fluid inside a thin lining of tissue called the pericardium. Another name for it is the pericardial sac. Inflammation of the pericardium causes the lining around the heart to become irritated and swell. This is called pericarditis.
Patients may develop pericarditis shortly after getting radiation treatment. Over time, they can develop constrictive pericarditis where the pericardium becomes stiff and thick.
Treatment options include medication and procedures to treat symptoms of heart failure. For advanced constrictive pericarditis, a heart surgeon may perform a pericardiectomy to remove the lining around the heart.
Irregular Heart Rhythms
Your heart has a conduction system, or an internal electrical system. This system provides the power for the heart to beat and pump blood to the body. Exposure to radiation can injure the conduction system. It can become inflamed, resulting in irregular heart rhythms.
Treatment options include: