Radiation-Induced Left-Sided Valvular Heart Disease

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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.