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Symptomatic cardiotoxicity with high-dose 5-fluorouracil infusion: a prospective study
S S Akhtar1, K P Salim, Z A Bano
1Department of Medical Oncology, SK Institute of Medical Sciences, Soura, Srinagar.
Oncology
|November 1, 1993
Summary
5-fluorouracil (5-FU) chemotherapy can cause cardiotoxicity, including chest pain and heart abnormalities. Symptoms often reverse upon stopping treatment, especially in patients without prior heart conditions.
Area of Science:
- Oncology
- Cardiology
Background:
- Cardiotoxicity is a known risk of 5-fluorouracil (5-FU) chemotherapy.
- Reported effects range from mild EKG changes to severe cardiac events like myocardial infarction.
Purpose of the Study:
- To prospectively identify patients developing symptomatic cardiotoxicity during 5-FU infusion.
- To characterize the symptoms, timing, and reversibility of 5-FU-induced cardiotoxicity.
Main Methods:
- 100 consecutive patients receiving 5-FU (alone or with other agents) were studied.
- Exclusion criteria included pre-existing cardiac conditions or abnormalities.
- Patients were monitored with daily EKGs; symptomatic patients received closer monitoring until symptom resolution.
Main Results:
- Eight patients (8%) developed symptomatic cardiotoxicity.
- Chest pain (5/8) was the most frequent symptom, followed by palpitations and sweating.
- One patient experienced cardiogenic shock; cardiac enzymes remained normal. Symptoms reversed rapidly upon treatment cessation in most patients.
Conclusions:
- 5-FU infusion carries a significant risk of symptomatic cardiotoxicity, potentially influenced by combination chemotherapy.
- Cardiotoxicity appears reversible, particularly in patients without prior cardiac disease.
- Prompt recognition and management of cardiotoxicity symptoms are crucial.