Radiation heart disease is a side effect of radiation therapy for cancers in the chest and includes a wide range of heart conditions. Because it can occur many years after exposure, close monitoring is essential. Advances in cancer radiation technology are reducing radiation exposure to the heart and the risk of heart disease.
Radiation therapy is a common treatment for people with cancer. Radiation treatment uses beams of energy to destroy cancer cells. If you receive radiation therapy to your chest, it can damage your heart.
Radiation heart disease describes a range of heart problems that occur due to radiation therapy. These problems can develop weeks or years after receiving radiation therapy.
Radiation heart disease occurs most often in people who receive treatment for:
Radiation can injure the tissues in and around your heart. Short-term, this can cause inflammation. Over time, these tissues may become tough and fibrous, and unable to function properly.
The heart tissues most often affected by radiation therapy include the:
The main short-term side effects occur in the pericardium (tissue around the heart). These include pericarditis and pericardial effusion. These conditions generally occur weeks to months after radiation therapy. They’re more common in people who have undergone treatment for Hodgkin lymphoma.
Longer-term complications may not show up for years, sometimes up to 20 years. These heart conditions include:
You could be at risk of heart disease after receiving radiation to your chest, especially your left side, which houses your heart. The unit of measurement for radiation is called a Gray (Gy). A total dose of more than about 30 Gy over a series of radiation treatments increases your risk of radiation heart disease.
Other factors that increase your risk for radiation-induced heart disease include:
Health conditions and behaviors can also increase your risk of radiation heart disease. These include:
As researchers recognized the risk of cardiotoxicity many years ago, experts have developed newer and safer technologies that minimize radiation to your heart. As a result, fewer people are developing radiation heart disease.
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Radiation therapy for treating cancers in your chest can cause radiation heart disease. The radiation destroys cancer cells but can also damage nearby heart tissues.
Symptoms of radiation heart disease vary by how soon they appear and the type of heart condition the radiation has caused.
Short-term side effects of radiation therapy include pericarditis and pericardial effusion. The main sign of both conditions is severe chest pain that:
You may also experience shortness of breath (dyspnea) that improves when you bend over.
Radiation heart disease may not cause any symptoms until it progresses. Your symptoms will depend on the type of heart condition you have. In general, the signs of heart disease include:
Heart attack and cardiac arrest are life-threatening emergencies. If you suspect you or someone you’re with is experiencing a heart attack or cardiac arrest, don’t hesitate to call 911 (or your local emergency services phone number). Time is critical, and a delay of even a few minutes can result in permanent damage or death.
Healthcare providers use many types of tests to diagnose radiation heart disease. The types of tests used depend on your symptoms and medical history. In addition to a physical exam and blood tests, your provider may order one or more of these tests:
Treatments for heart disease range from lifestyle changes and medications to minimally invasive and surgical treatments. Your provider will work with you to determine the right treatment approach for you.
Advances in heart disease treatment are helping people live longer with better quality of life.
The main strategy for preventing radiation heart disease is limiting the amount of radiation your heart receives.
Advanced cancer radiation technologies deliver precise doses of radiation to the tumor and reduce the amount of radiation the surrounding tissues receive. These include:
Positioning can also help reduce radiation exposure to your heart during breast cancer treatment. For example, you may receive treatment while lying on your stomach or in short bursts when you take a deep breath.
If you’ve received chest radiation, you can lower your risk of developing heart disease by leading a heart-healthy lifestyle. This includes:
Routine follow-up care after you complete cancer treatment is also essential to monitor your overall health. Your provider may order routine tests every five to 10 years to check your heart function.
As more people are surviving cancer and living longer, knowledge about the long-term effects of treatment is expanding. The risk of developing heart disease increases the longer you live after cancer treatment. But technologies that reduce radiation exposure to the heart are lowering this risk.
Your individual outlook depends on:
Call your healthcare provider right away if you experience any symptoms of heart disease. These include chest pain or discomfort, shortness of breath or an irregular heartbeat.
Seek emergency care right away if you suspect you may be experiencing a heart attack or cardiac arrest.
A note from Cleveland Clinic
People who received cancer radiation therapy to their chest can develop radiation-induced heart disease years later. But recent advances in radiation technology mean fewer people are developing heart disease from the effects of radiation. Heart disease treatment options are also improving and allow for better quality of life. Let your healthcare provider know if you’ve received radiation therapy in the past and if you experience any symptoms of heart disease.
Last reviewed by a Cleveland Clinic medical professional on 09/07/2022.
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