Acute myocardial infarction with normal coronary arteriogram after mantle field radiation therapy for Hodgkin's disease

A case of an acute myocardial infarction occurring in a 19‐year‐old woman, 27 months after mantle radiotherapy for Stage II‐A Hodgkin's disease is described. The coronary arteriogram demonstrated patent and normal coronary arteries, but the echocardiogram revealed pericarditis. The clinical course was further complicated by variant type of angina pectoris which could not be prevented by treatment with vasodilators, but subsided promptly to corticosteroid therapy. It is suggested that radiation induced pericarditis triggered coronary vasospasm leading to the myocardial infarction and to variant angina pectoris.