[The development of myocardial infarct in a patient treated with 5-fluorouracil]

The authors describe the first case of myocardial infarction in their department which occurred during 5-fluorouracil treatment. In a 37 year-old patient two years before the infarction an epidermoid carcinoma of the lower lip was found. The patient was subjected to operation and radiotherapy. Because of a relapse of the process after one year the patient was re-operated with subsequent chemotherapy (vincristine, methotrexate, cis-platinum). Because the effect was not satisfactory, after another year 5-fluorouracil treatment was started (i.v. infusion of 3000 mg in two days). In the course of the infusion the patient developed the clinical picture of a non-transmural infarction of the anterior wall. The course was uncomplicated. The ECG returned to normal on the 9th day after discontinuation of 5-fluorouracil treatment. The effect of 5-fluorouracil on the heart is explained by a coronary vascular spasm. The authors recommend therefore administration of calcium blockers.