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Acute myocardiotoxicity during 5-fluorouracil therapy
B Misset1, B Escudier, B Leclercq
1Service de Réanimation Médico-Chirurgicale, Institut G. Roussy, Villejuif, France.
Intensive Care Medicine
|January 1, 1990
Summary
A patient experienced severe heart failure during 5-fluorouracil (5-FU) chemotherapy. This case highlights a rare cardiac event linked to 5-FU, potentially due to drug accumulation in the heart.
Area of Science:
- Cardiology
- Oncology
- Pharmacology
Background:
- 5-fluorouracil (5-FU) is a common chemotherapy agent.
- Cardiac adverse events, including coronary insufficiency, are known side effects of 5-FU.
- The exact mechanism of 5-FU cardiotoxicity requires further elucidation.
Observation:
- A 38-year-old man with colon cancer developed cardiogenic shock during continuous intravenous 5-FU therapy.
- The patient had no signs of coronary insufficiency and a normal coronary angiogram.
- Symptoms resolved with inotropic and vasodilator treatment.
Findings:
- This is the first reported case of acute cardiac failure without coronary ischemia associated with 5-FU monotherapy.
- Experimental data suggest myocardial accumulation of 5-FU may lead to depletion of high-energy phosphate compounds.
- This mechanism could explain both acute cardiac failure and coronary insufficiency.
Implications:
- Clinicians should be aware of the potential for severe cardiac dysfunction with 5-FU, even without ischemic signs.
- Further research into the cardiotoxic mechanisms of 5-FU is warranted.
- Monitoring cardiac function in patients receiving 5-FU may be beneficial.