Variant angina pectoris associated with FOLFOX4 therapy

Area of Science:

• Oncology
• Cardiology
• Pharmacology

Background:

• Colon cancer management often involves chemotherapy regimens like FOLFOX4.
• Adverse events associated with chemotherapy require careful monitoring and understanding.

Purpose of the Study:

• To report a rare case of acute coronary syndrome (ACS) as an adverse effect of FOLFOX4 chemotherapy.
• To raise awareness among clinicians regarding potential cardiac complications during FOLFOX4 treatment.

Main Methods:

• Case report of a 71-year-old male patient with metastatic colon cancer treated with FOLFOX4.
• Clinical observation of symptoms (chest pain, itching) during chemotherapy administration.
• Diagnostic workup including electrocardiogram and coronary arteriography.

Main Results:

• The patient developed chest pain and itching during FOLFOX4 administration.
• Electrocardiogram showed signs of ischemia; coronary arteriography revealed intact coronary arteries.
• Symptoms recurred, leading to discontinuation of FOLFOX4 therapy.
• The adverse event was identified as acute coronary syndrome (ACS), specifically variant angina.

Conclusions:

• FOLFOX4 chemotherapy can be associated with rare but serious cardiac adverse events like variant angina.
• Clinicians should maintain a high index of suspicion for ACS in patients receiving FOLFOX4.
• Awareness and monitoring are crucial for managing potential cardiotoxicity of chemotherapy agents.