The survival rate in Hodgkin lymphoma, Non-Hodgkin's lymphoma and breast carcinomas has significantly improved with use of<unk>  therapy.However,<unk>  therapy to thoracic and mediastinal cancers have also led to the development of pericarditis, coronary artery disease, cardiomyopathy, conduction abnormalities in heart and valvular heart diseases which account for significant morbidity and mortality.<unk>  was first described in the mid-1960s. The<unk><unk>  pericardial disease may be classified as acute pericarditis, delayed pericarditis, pancarditis, constrictive pericarditis, and pericardial effusion.<unk>  therapy leads to disruption of endothelium and subsequent episodes of ischemia. The resulting fibrosis and fibrinous exudates replace collagen fibers.<unk><unk>  pericardial disease can occur in any cancer survivor who receive thoracic<unk>  therapy, including breast cancer, Hodgkin's lymphoma, esophageal cancer, and lung cancer.<unk>  depends on the total dose of<unk> , the dose per fraction, the amount of cardiac silhouette exposed, and the nature of the<unk>  source. The incidence is higher with doses greater than 40 Gy (4000 rad). Echocardiography is the most commonly used screening modality for the detection and follow-up of<unk><unk>  cardiac disease. Acute pericarditis usually develops a few weeks after<unk>  exposure. Nearly 20% of patients with acute pericarditis develop chronic or constrictive pericarditis in the next 5-10 years following<unk>  therapy. The risk is increased when pericardial effusion was present previously. Chronic pericarditis can also occur in patients without a history of acute pericarditis. Acute pericarditis is a rare complication of<unk>  therapy. It presents with nonspecific pericarditis symptoms such as chest pain and fever shortly after<unk>  therapy. Delayed pericarditis occurs from months to years after exposure to<unk> . It usually presents with chest pain, dyspnea, and orthopnea. The physical examination may show fever and pericardial rub. Laboratory findings include elevated inflammatory markers such as neutrophil count and erythrocyte sedimentation rate (ESR). On ECG, non-specific ST and T wave changes or ST-segment elevation in all leads may be noted. The majority of acute pericarditis cases are self-limited and respond well to nonsteroidal anti-inflammatory drugs and colchicine. In acute or chronic pericarditis, protein-rich exudate may accumulate in the pericardial sac leading to pericardial effusion. Findings on a chest x-ray or chest CT suggestive of chronic pericarditis include pericardial effusion and pericardial thickening. If the effusion is large enough, it may lead to tamponade. In patients presenting with tamponade, the physical examination may show hypotension, tachycardia, and jugular venous distention with a prominent Y descent, Kussmaul’s sign, and distant heart sound.<unk><unk>  pericardial effusion can be confused with malignant pericarditis and hypothyroidism-induced pericarditis. Pericarditis with large effusion can be drained either percutaneously or surgically. Those with recurrent pericardial effusion can be treated with pericardiotomy(pericardial window) or by surgical stripping. Constrictive pericarditis is a late complication of<unk>  therapy. Patients typically present with signs and symptoms of heart failure, similar to other causes of constrictive pericarditis. Cardiac MRI may be helpful in the diagnosis of constrictive pericarditis. It is useful to confirm the pericardial thickening. Cardiac catheterization may be also helpful in the diagnosis of constrictive pericarditis associated with<unk>  therapy. Pericardiectomy is recommended for patients who develop constrictive pericarditis. However, the perioperative mortality rate is higher in<unk><unk>  constrictive pericarditis compared to that of idiopathic constrictive pericarditis. Effective measures for the primary prevention of<unk>  include reducing the dose and volume of cardiac irradiation when possible.
Radiation induced pericarditis
Cholesterol pericarditis
Tuberculous pericarditis
Libman-Sacks endocarditis
Post myocardial infarction pericarditis
Infective endocarditis
Pericarditis in malignancy
Stress cardiomyopathy