Fluorouracil (5-FU)-induced Cardiomyopathy

Area of Science:

• Oncology
• Cardiology
• Pharmacology

Background:

• Fluorouracil (5-FU) is a cornerstone chemotherapy agent for solid tumors, often used with radiotherapy due to its radiosensitizing effects.
• While effective, 5-FU is associated with various adverse events, including potentially life-threatening cardiotoxicity.
• Cardiotoxicity from 5-FU can manifest in diverse clinical presentations.

Observation:

• A 42-year-old male patient experienced atypical chest pain shortly after receiving his initial dose of 5-FU.
• Diagnostic evaluation confirmed the chest pain was a manifestation of 5-FU-induced cardiotoxicity.
• The patient's cardiac function returned to normal following the cessation of 5-FU therapy.

Findings:

• This case illustrates a direct link between 5-FU administration and the onset of cardiac adverse events.
• Prompt recognition and drug withdrawal led to the resolution of cardiotoxicity.
• The pyrimidine analog 5-FU can precipitate acute cardiac complications in susceptible individuals.

Implications:

• Clinicians should maintain a high index of suspicion for cardiotoxicity in patients receiving 5-FU, especially those presenting with chest pain.
• Early detection and management, including drug discontinuation, are crucial for favorable cardiac outcomes.
• Understanding the cardiotoxic potential of 5-FU is vital for optimizing cancer treatment strategies and patient safety.