open access

Vol 15, No 6 (2020)
Case report
Published online: 2020-12-30
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Sinus node dysfunction as a late complication of Hodgkin lymphoma treatment

Paulina Daniluk, Grzegorz Sławiński, Izabela Nabiałek-Trojanowska, Ewa Lewicka
DOI: 10.5603/FC.2020.0062
·
Folia Cardiologica 2020;15(6):424-427.

open access

Vol 15, No 6 (2020)
Case Reports
Published online: 2020-12-30

Abstract

Cardiotoxicity and cardiovascular complications associated with radiation therapy can be revealed many years after oncological therapy, most often 15-20 years after this treatment. A 45-year-old man was admitted to hospital due to syncope with accompanying head injury. At the age of 30, he was diagnosed with Hodgkin lymphoma (clinical stage III) and underwent chemotherapy (including doxorubicin), followed by thoracic radiotherapy. Complete remission of the disease was achieved and the patient remained under constant hematological control for the following years. On admission to the hospital, sinus bradycardia up to 25 bpm was recorded in electrocardiographic (ECG) examination, without other abnormalities. ECG monitoring carried out in the following hours revealed episodes of sinus arrest (up to 17 seconds). Laboratory test results were in the normal range. Transthoracic echocardiography showed no abnormalities. Oncological treatment has been considered the most likely cause of sinus node damage. Due to symptomatic sinus node dysfunction, the patient was implanted with a dual chamber pacemaker. The presented case report confirms the need for indefinite cardiological supervision in patients after oncological treatment in childhood or youth, especially when thorax irradiation and chemotherapy with proven cardiotoxicity were required.

Abstract

Cardiotoxicity and cardiovascular complications associated with radiation therapy can be revealed many years after oncological therapy, most often 15-20 years after this treatment. A 45-year-old man was admitted to hospital due to syncope with accompanying head injury. At the age of 30, he was diagnosed with Hodgkin lymphoma (clinical stage III) and underwent chemotherapy (including doxorubicin), followed by thoracic radiotherapy. Complete remission of the disease was achieved and the patient remained under constant hematological control for the following years. On admission to the hospital, sinus bradycardia up to 25 bpm was recorded in electrocardiographic (ECG) examination, without other abnormalities. ECG monitoring carried out in the following hours revealed episodes of sinus arrest (up to 17 seconds). Laboratory test results were in the normal range. Transthoracic echocardiography showed no abnormalities. Oncological treatment has been considered the most likely cause of sinus node damage. Due to symptomatic sinus node dysfunction, the patient was implanted with a dual chamber pacemaker. The presented case report confirms the need for indefinite cardiological supervision in patients after oncological treatment in childhood or youth, especially when thorax irradiation and chemotherapy with proven cardiotoxicity were required.

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Keywords

Hodgkin lymphoma; sinus node dysfunction; radiotherapy; cardiotoxicity; oncological treatment; cardiooncology

About this article
Title

Sinus node dysfunction as a late complication of Hodgkin lymphoma treatment

Journal

Folia Cardiologica

Issue

Vol 15, No 6 (2020)

Article type

Case report

Pages

424-427

Published online

2020-12-30

DOI

10.5603/FC.2020.0062

Bibliographic record

Folia Cardiologica 2020;15(6):424-427.

Keywords

Hodgkin lymphoma
sinus node dysfunction
radiotherapy
cardiotoxicity
oncological treatment
cardiooncology

Authors

Paulina Daniluk
Grzegorz Sławiński
Izabela Nabiałek-Trojanowska
Ewa Lewicka

References (9)
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