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An unusual case of chronic coronary artery dissection: did cisplatin play a role?

Nina Ghosh1, Chi-Ming Chow, Victoria Korley

  • 1Division of Cardiology, University of Toronto, Toronto, Canada.

The Canadian Journal of Cardiology
|October 9, 2008
PubMed

Insights

Spontaneous coronary artery dissection (SCAD) can cause myocardial ischemia. This case shows SCAD persisting for 12 years post-chemotherapy, highlighting long-term cardiovascular risks in cancer survivors.

Area of Science:

  • Cardiology
  • Oncology
  • Vascular Biology

Background:

  • Spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute myocardial ischemia.
  • The long-term course of SCAD, particularly when persistent on angiography, remains poorly understood.
  • Testicular cancer survivors treated with chemotherapy may face increased cardiovascular risks.

Observation:

  • A 36-year-old man with a history of testicular cancer treated with bleomycin-etoposide-cisplatin developed ventricular tachycardia 12 years post-treatment.
  • Coronary angiography revealed a chronic dissection of the right coronary artery.
  • The patient's condition was managed medically with an implantable cardioverter defibrillator.

Findings:

  • Chronic spontaneous coronary artery dissection can persist for over a decade.
  • Chemotherapy regimens for testicular cancer are associated with significant long-term cardiovascular morbidity.
  • Atherosclerosis may not be the sole mechanism for myocardial ischemia in young cancer survivors.

Implications:

  • This case underscores the importance of long-term cardiovascular surveillance in testicular cancer survivors.
  • It suggests non-atherosclerotic mechanisms may contribute to myocardial ischemia in this population.
  • Further research is needed to elucidate the specific cardiovascular impacts of chemotherapy and SCAD.

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