Radiation-Induced Heart Disease (RIHD)

Posted by sosser @sosser, Oct 26, 2023

I'm a 71 year old woman (28 year breast cancer survivor) recently diagnosed with Grade 1 diastolic dysfunction. The diagnosis came after an EKG, an echocardiogram, and a 72 hour holter monitor test. I was then prescribed 25mg of metoprolol once a day. I'm 30 pounds overweight, but otherwise have no underlying conditions (high blood pressure, diabetes, etc.) and no family history of heart disease. 28 years ago, I was treated for left breast cancer, and underwent 4 rounds of chemotherapy and 6 + weeks of radiation. While researching heart disease, I've found that decade laters people can develop radiation-induced heart disease due to radiation to their left chest area. Has anyone been diagnosed with RIHD? What were your symptoms? Treatment? I'm presently in an HMO, so limited to seeing a specialist in RIHD.

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76 yr old woman….yes, I developed a fib after 14 rounds of radiation…..supposed to have 30 rounds but quit because side effects did me in…….this week I had cardioversion( they shock the heart…in hospital)……worked, normal rhythm now…..in Ontario, Canada

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So glad it worked, and you're in normal rhythm! Thanks for sharing.

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Hello. Sorry about your recent developments. About all I can say is that the weight you are carrying 'could be' the progenitor of your heart's woes. Unfortunately, as we age, we often do poorly with sleep, and that's a recipe for weight gain due to increased blood cortisol and insulin overuse. With that weight gain, we deposit more visceral fat than normally, or at least than in years long past, and some of that gets deposited around the heart. It can make the heart cranky. Your 'pipes' are clean, apparently? An angiogram or echo showed no stenoses? No mitral valve prolapse? Ejection fraction is nominal?

It is quite common for people to present to an ER with an arrythmia, at which, with tests confirming nothing else untoward, no electrolyte deficiencies or overabundances, etc, they'll offer to cardiovert. Often, that works well, first shock, and the patient is soon on his/her way back home. Unfortunately for me, none of the four I had worked for more than a few hours. Soon I was back in AF, but it's another long story. Happy to say that I am now in NSR after other interventions.

Please do consider losing at least 15 pounds. It can't help but do you some good, and may reduce deposits that are making your heart cranky. It's an idea, just a suggestion from a layman. If you could stand a pointed suggestion, please do consider reducing your carbohydrate consumption, of all kinds, all food and drink, to less than 150 grams per day, even lower if it isn't too much of a bother for you. This will keep your insulin response to a minimum, which means less storage of unused calories.

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@gloaming

Hello. Sorry about your recent developments. About all I can say is that the weight you are carrying 'could be' the progenitor of your heart's woes. Unfortunately, as we age, we often do poorly with sleep, and that's a recipe for weight gain due to increased blood cortisol and insulin overuse. With that weight gain, we deposit more visceral fat than normally, or at least than in years long past, and some of that gets deposited around the heart. It can make the heart cranky. Your 'pipes' are clean, apparently? An angiogram or echo showed no stenoses? No mitral valve prolapse? Ejection fraction is nominal?

It is quite common for people to present to an ER with an arrythmia, at which, with tests confirming nothing else untoward, no electrolyte deficiencies or overabundances, etc, they'll offer to cardiovert. Often, that works well, first shock, and the patient is soon on his/her way back home. Unfortunately for me, none of the four I had worked for more than a few hours. Soon I was back in AF, but it's another long story. Happy to say that I am now in NSR after other interventions.

Please do consider losing at least 15 pounds. It can't help but do you some good, and may reduce deposits that are making your heart cranky. It's an idea, just a suggestion from a layman. If you could stand a pointed suggestion, please do consider reducing your carbohydrate consumption, of all kinds, all food and drink, to less than 150 grams per day, even lower if it isn't too much of a bother for you. This will keep your insulin response to a minimum, which means less storage of unused calories.

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Thank you for your response. Weight loss is always important and a work in progress. Happy you're in NSR.

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@gloaming

Hello. Sorry about your recent developments. About all I can say is that the weight you are carrying 'could be' the progenitor of your heart's woes. Unfortunately, as we age, we often do poorly with sleep, and that's a recipe for weight gain due to increased blood cortisol and insulin overuse. With that weight gain, we deposit more visceral fat than normally, or at least than in years long past, and some of that gets deposited around the heart. It can make the heart cranky. Your 'pipes' are clean, apparently? An angiogram or echo showed no stenoses? No mitral valve prolapse? Ejection fraction is nominal?

It is quite common for people to present to an ER with an arrythmia, at which, with tests confirming nothing else untoward, no electrolyte deficiencies or overabundances, etc, they'll offer to cardiovert. Often, that works well, first shock, and the patient is soon on his/her way back home. Unfortunately for me, none of the four I had worked for more than a few hours. Soon I was back in AF, but it's another long story. Happy to say that I am now in NSR after other interventions.

Please do consider losing at least 15 pounds. It can't help but do you some good, and may reduce deposits that are making your heart cranky. It's an idea, just a suggestion from a layman. If you could stand a pointed suggestion, please do consider reducing your carbohydrate consumption, of all kinds, all food and drink, to less than 150 grams per day, even lower if it isn't too much of a bother for you. This will keep your insulin response to a minimum, which means less storage of unused calories.

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Gloaming, you may be a layperson (I am, too), but you write exceedingly well about your subject. Weight gain after menopause is so common. I think it was comic Joan Rivers who noted, “There is no woman over 50 in America with a flat stomach.” Where did you come up with the 150 number for carbs? Unfortunately, I have never met a carb I didn’t fall in love with. But it’s more fortunate that I have willpower now generated by 67 years of vanity.

I never knew radiation caused heart issues until I met a woman who lost her very young daughter to a heart attack; alas, it was not breast cancer that ended her life, but its treatment.

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Thank-you for the compliment, Barbara (my wife's name, incidentally). When I was very young, our family would go on a vacation once a year to a place where an elderly gentleman stayed year-round. He was the target of my inquisitiveness on many occasions, and he began to call me 'How Come?' When we'd show up at the start of each vacation, he'd ask my parents, 'Where's How Come?'

I have a strong aversion to ignorance, or to misunderstanding, and I have a high requirement for the late psychologist Julian Rotter's model of social learning called 'locus of control'. You may be familiar with this concept, but I have a strong internal locus of control. Those with an external locus of control feel that they have less power to control their lives or their circumstances, whereas people like me try to make things happen. It's that way with learning, with my hobbies, my interests, with music, equipment of all descriptions, etc. I gotta know!!

It happens that somewhere along the way I picked up some skill in relating it to others. I have learned though, to watch for glazed eyes, and for glancing at watches. 😀

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