5-fluorouracil-induced coronary vasospasm: A cardiovascular magnetic resonance imaging case report

We report the case of a 45-year old male with metastatic colon cancer who presented with chest pain and transient diffuse ST-segment elevation on electrocardiogram after his third cycle of FOLFOX (folinic acid, fluorouracil, oxaliplatin). Initial transthoracic echocardiogram showed reduced left ventricular ejection fraction of 35% with mildly elevated troponins. Further investigations with cardiovascular magnetic resonance imaging demonstrated recovery of left ventricular function with evidence suggestive of coronary vasospasm. This case report will review the utility of cardiovascular magnetic imaging in the evaluation of underlying etiologies for myocardial injury in patients with low likelihood of obstructive coronary artery disease.