Unstable angina in a young woman with Hodgkin’s lymphoma

We present the case of a 30 year-old woman — 16 months after successful treatment of Hodgkin’s lymphoma (chest location) with chemotherapy (including doxorubicin) and radiotherapy — with recurrent chest pain and dyspnea. In ambulatory event telemetry, she reported nocturnal chest pain with transient ST elevation characteristic for acute cardiac ischemia. Urgent coronary angiography with intravascular ultrasound and virtual histology visualization revealed 70% fibrotic stenosis in the proximal segment of the left anterior descending artery successfully treated with a drug-eluting stent implantation. This case is especially noteworthy because of the short period from initial therapy to the symptomatic coronary artery disease that is entirely unlike the reported mean latency period of several years.