We present a case in which a 37-year-old female died of acute myocardial infarction. The patient was 20 years earlier successfully treated with radiation therapy against the mediastinum for Hodgkin's disease. Nearly half of the patients with Hodgkin's disease are younger than 40 years at the time of diagnosis. Most of them are successfully treated with radiation therapy. Radiation against mediastinum including parts of the heart can induce fibrotic changes in the coronary arteries. We conclude that the radiation therapy was the main etiologic factor behind the patient's coronary artery disease. It is important to use techniques with the lowest possible risk for damaging the coronary arteries under chest radiation therapy. It is also important to perform early checks for coronary artery disease in this category of patients when they present with chest pain.