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Ischemic heart disease associated with vincristine and doxorubicin chemotherapy
J M Calvo-Romero1, R Fernández-Soria-Pantoja, J D Arrebola-Garcia
1Department of Internal Medicine, Clideba Clinic, Badajoz, Spain.
Objective:
To report the ocurrence of ischemic heart disease (IHD) in a patient with multiple myeloma treated with vincristine and doxorubicin.
Case Summary:
A 46-year-old man developed a Q-wave inferior and right-ventricle myocardial infarction with postinfarction angina after receiving his third cycle of vincristine and doxorubicin for immunoglobulin A multiple myeloma. Angiography showed two small filling defects consistent with thrombi in the distal right coronary artery.
Discussion:
IHD may be a serious but uncommon complication of treatment with several chemotherapeutic agents. It is likely that chemotherapy played a role in the development of IHD in our patient. Several putative mechanisms for vascular toxicity have been associated with chemotherapy.
Conclusions:
Chemotherapy with vincristine and doxorubicin may play a role in the ocurrence of IHD. Physicians should possess an awareness of this potentially serious complication of chemotherapy.