Left main coronary artery stenosis following mediastinal irradiation

The association of mediastinal radiation therapy and coronary artery disease has been documented over the past three decades. This report describes a case of left main coronary artery stenosis eight years after radiation therapy in a 27-year-old woman. The patient was a young woman with no risk factors for coronary artery disease who had development of new-onset angina at rest. At coronary arteriography, the patient was found to have a tight ostial left main stenosis. The association of mediastinal radiation therapy with fixed and vasospastic coronary artery disease is reviewed. With many patients treated by radiation therapy now surviving their thoracic malignancies, an enlarging young population may be susceptible to the early development of ischemic heart disease.