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Coronary Artery Disease III: Clinical Manifestations01:30

Coronary Artery Disease III: Clinical Manifestations

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Coronary Artery Disease (CAD) is a primary health risk worldwide, leading to significant morbidity and mortality. The condition arises from the buildup of atherosclerotic plaques within the coronary arteries, resulting in diminished blood supply to the heart muscle.The clinical manifestations of CAD vary widely, from asymptomatic stages to severe, life-threatening conditions. Understanding these manifestations is crucial for early diagnosis and effective management.Angina Pectoris: The Warning...
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Acute Coronary Syndrome I: Introduction01:30

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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

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Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
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Imaging Studies for Cardiovascular System V: CT01:28

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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Angina pectoris, a primary symptom of ischemic heart disease, requires careful pharmacological interventions. In this context, calcium channel blockers (CCBs) and ranolazine have emerged as crucial pharmacotherapeutic agents, providing deep insights into the complexities of angina management.
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Capecitabine-Induced Coronary Vasospasm.

Danish Henry1, Francine Rudzik1, Allison Butts1

  • 1Markey Cancer Center, University of Kentucky, Lexington, Ky., USA.

Case Reports in Oncology
|December 7, 2016
PubMed
Summary

Capecitabine, an oral chemotherapy, can cause coronary vasospasm, a rare but serious cardiac event. This case highlights the need for awareness of capecitabine

Keywords:
5-FluorouracilBreast cancerCapecitabineChest painCoronary artery disease

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Area of Science:

  • Oncology
  • Cardiology
  • Pharmacology

Background:

  • Capecitabine is an oral prodrug of 5-fluorouracil (5-FU) used for colorectal and breast cancers.
  • While 5-FU cardiotoxicity is known, cardiac adverse effects of capecitabine are less documented.
  • Understanding capecitabine's cardiac risks is crucial for patient safety.

Observation:

  • A 41-year-old female with metastatic breast cancer developed chest pain 3 days after initiating capecitabine.
  • Symptoms included exertional chest pain, relieved by rest, with a heart rate of 100 bpm.
  • Initial cardiac workup (ECG, troponin, CT angiography, echocardiogram) was unremarkable for acute ischemia or embolism.

Findings:

  • The patient's presentation was consistent with coronary vasospasm induced by capecitabine.
  • Chest pain resolved with aspirin and analgesics.
  • Capecitabine treatment was discontinued due to the suspected adverse cardiac event.

Implications:

  • This case underscores the potential for capecitabine to induce coronary vasospasm.
  • Clinicians should consider vasospasm in patients on capecitabine presenting with cardiac symptoms.
  • Further research is needed to elucidate the incidence and mechanisms of capecitabine-associated cardiotoxicity.