Silent ischemic cardiomyopathy and left coronary ostial stenosis secondary to radiation therapy

Abstract

A 55-year-old woman presented with profound congestive heart failure 23 years following mediastinal radiation. Ejection fraction (EF) was 35%. Symptoms markedly improved and EF increased to >55% following saphenous vein bypass for ≤80% ostial left main stenosis. Radiation therapy, a known risk factor for coronary atherosclerosis, may present with reversible severe silent ischemia.