A high index of suspicion followed by multimodality imaging may be crucial in radiation-associated cardiac disease, along with comprehensive screening to enable early detection, according to an Expert Panel review published Aug. 12 in the Journal of the American College of Cardiology.

Milind Y. Desai, MBBS, FACC, et al., provides a focused overview of radiation-associated cardiac disease, including prevalence, clinical and imaging manifestations, screening recommendations, and therapeutic options based on cumulative experience over the last 20 years.

The authors explain that presentation of radiation-associated cardiac disease is vague and overlaps with many diseases, presenting unique diagnostic and management issues. They encourage the timing of intervention to be carefully considered in these patients, as surgery is often complex with an emerging role of percutaneous interventions.

Furthermore, the authors strongly advocate for coordinated management by an experienced team of providers at a center of excellence. They add that developing comprehensive multimodality imaging-based screening protocols would allow physicians to adequately identify those at risk, plan interventions and evaluate treatment response.

"The longer-term future should involve developing radiotherapy delivery protocols that minimize the chances of developing radiation-associated cardiac disease in the future," the authors conclude.

This article has been selected as the month's JACC CME/MOC/ECME activity, available online at ACC.org.

Keywords: Radiation Injuries, Heart Diseases

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