5-Fluorouracil cardiotoxicity: reversible left ventricular systolic dysfunction with early detection
Muhammad Zaid Iskandar1, Wahid Quasem2, Magdi El-Omar3
1Department of Cardiology, Ninewells Hospital, Dundee, UK.
BMJ Case Reports
|May 4, 2015
Summary
A patient experienced severe heart dysfunction after 5-fluorouracil (5-FU) chemotherapy for colon cancer. Prompt treatment led to full recovery, highlighting the reversible nature of 5-FU cardiotoxicity.
Area of Science:
- Cardiology
- Oncology
- Pharmacology
Background:
- 5-fluorouracil (5-FU) is a common chemotherapy agent for colorectal cancer.
- Cardiotoxicity is a known but often under-recognized side effect of 5-FU.
- Early detection and management are crucial for patient outcomes.
Observation:
- A 33-year-old man developed acute shortness of breath and ECG changes 3 days post-5-FU.
- Echocardiogram revealed severe left ventricular systolic dysfunction despite no prior cardiac history.
- Coronary angiogram was normal, ruling out acute coronary syndrome.
Findings:
- Treatment with heart failure medications, nitrates, and calcium channel blockers was initiated.
- Chemotherapy (5-FU) was discontinued.
- Repeat echocardiogram and cardiac MRI showed complete resolution of left ventricular dysfunction within a week.
Implications:
- This case underscores the potential for severe, yet reversible, cardiotoxicity from 5-FU.
- Highlights the importance of cardiac monitoring in patients receiving 5-FU.
- Early recognition and appropriate medical management can lead to favorable outcomes in 5-FU-induced cardiotoxicity.
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