Persistent Shortness of Breath in a Survivor of Childhood Cancer
A 46-year-old male patient with a past medical history of Hodgkin's stage IIb lymphoma at age 13 treated with chemotherapy (agents unknown) and radiation therapy presents for worsening shortness of breath over the past 20+ years, though it was been notably worse over the past couple months. For most of his adult life, he has felt like he could not exert himself like his peers. Now he can barely climb a flight of stairs. Videos 1-2 and Figures 1-4 show the echocardiography and catheterization findings.
Based on the echocardiography and catheterization findings, what is the primary etiology of his heart disease?