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Related Experiment Videos

5-fluorouracil-induced coronary vasospasm.

Laura K Shoemaker1, Umesh Arora, Caio M Rocha Lima

  • 1Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. laurakshoemaker@yahoo.com

Cancer Control : Journal of the Moffitt Cancer Center
|January 30, 2004
PubMed
Summary

5-fluorouracil (5-FU) can cause cardiotoxicity, leading to chest pain due to coronary artery spasm. This rare but serious side effect necessitates prompt treatment discontinuation.

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Area of Science:

  • Oncology
  • Cardiology
  • Pharmacology

Background:

  • Cardiotoxicity is a known, though uncommon, adverse effect of 5-fluorouracil (5-FU).
  • The precise mechanism behind 5-FU-induced cardiotoxicity remains unclear.
  • This case report investigates a potential cause of this adverse event.

Observation:

  • A 63-year-old male patient undergoing treatment for metastatic colon cancer experienced chest pain.
  • The patient was receiving the FOLFIRI regimen, which includes continuous infusion of 5-FU.
  • Coronary artery spasm was observed during cardiac catheterization.

Findings:

  • Cardiac catheterization revealed significant coronary vasospasm in the obtuse marginal artery and a critical atherosclerotic plaque in the right coronary artery.

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  • Electrocardiogram findings indicated diffuse myocardial involvement, not localized to the right coronary artery.
  • The observed vasospasm occurred in conjunction with continuous 5-FU infusion.

    • Implications:

    • This case supports the vasospastic hypothesis for 5-FU-induced angina.
    • 5-FU-induced cardiotoxicity, while rare, can be life-threatening.
    • Discontinuation of 5-FU therapy and prompt patient management are crucial upon suspected cardiotoxicity.