Capecitabine induced cardiotoxicity: a case report and review of literature

Capecitabine is an oral prodrug of 5-fluorouracil (5-FU) which is converted in tumor cells to 5-FU by the enzyme thymidine phosphorylase. Nowadays, it is being widely used into the management of colorectal, breast and head and neck cancers because of its oral route and its comparable efficacy with 5-FU. 5-FU induced cardiotoxicity (angina and myocardial infarction) has been reported the literature, but capecitabine induced cardiotoxicity is less reported event. We report a patient with diagnosis of locally advanced adenocarcinoma of rectum who developed symptomatic bradycardia and acute ischemia while receiving oral capecitabine 825mg/m(2) twice daily with preoperative radiation.