Overview
Radiation therapy, particularly to the chest, is a well-documented risk factor for late-onset cardiovascular disease—including valvular heart disease, coronary artery disease, pericardial pathology, and conduction system abnormalities. Among these, valvular heart disease is a key complication that can emerge years to decades after exposure. This delayed presentation can make it challenging to distinguish from age-related degenerative changes.
Echocardiography—both transthoracic (TTE) and transesophageal (TEE)—is the first-line imaging modality for evaluating radiation-induced valvular changes.
Pathophysiology of Radiation Valvulopathy
Radiation leads to early valvular retraction causing regurgitation.
Over time, valves undergo fibrotic thickening and calcification, progressing to stenosis.