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Rare Presentation of Cardiotoxicity Related to 5-Fluorouracil

5-Fluorouracil (5-FU) is a chemotherapeutic agent frequently used for the treatment of solid tumors. In a few cases, 5-FU can be associated with coronary vasospasm, cardiac ischemia, or life-threatening arrhythmias. Recognition of 5-FU cardiotoxicity is clinically important as after the rapid sensat...

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Autores principales: Charkviani, Mariam, Murvelashvili, Natia, Barrera, Francisco, Sharma, Alisha, Eldin, Randa Sharag, Nabil, Nur Un Nisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7391081/
https://www.ncbi.nlm.nih.gov/pubmed/32774961
http://dx.doi.org/10.1155/2020/4151474
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author Charkviani, Mariam
Murvelashvili, Natia
Barrera, Francisco
Sharma, Alisha
Eldin, Randa Sharag
Nabil, Nur Un Nisa
author_facet Charkviani, Mariam
Murvelashvili, Natia
Barrera, Francisco
Sharma, Alisha
Eldin, Randa Sharag
Nabil, Nur Un Nisa
author_sort Charkviani, Mariam
collection PubMed
description 5-Fluorouracil (5-FU) is a chemotherapeutic agent frequently used for the treatment of solid tumors. In a few cases, 5-FU can be associated with coronary vasospasm, cardiac ischemia, or life-threatening arrhythmias. Recognition of 5-FU cardiotoxicity is clinically important as after the rapid sensation of therapy, cardiotoxicity can be completely reversible, and on the other hand, readministration may lead to serious damage of the heart and even death. A 70-year-old male came to the emergency department (ED) with chest pain which started while receiving an infusion of 5-FU. The patient did not have a personal history or risk factors of coronary artery disease and his electrocardiogram (ECG) before starting chemotherapy was completely normal. In the ED, his ECG had ischemic changes, troponin was elevated, and echocardiogram showed anterior wall hypokinesis. However, emergent coronary angiogram did not reveal any acute coronary occlusion. 5-FU-induced cardiotoxicity was suspected; the patient was admitted to a progressive care unit for close monitoring and infusion of calcium channel blockers was initiated. The patient's symptoms and ECG findings gradually resolved, and two days later on discharge, patient was chest pain free and ECG was normal. This case supports the vasospastic hypothesis of 5-FU cardiac toxicity, describes its clinical course, and emphasizes the importance of better awareness and early recognition of the rare side effect as it may allow physicians to reduce the risk of life-threatening complications.
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spelling pubmed-73910812020-08-06 Rare Presentation of Cardiotoxicity Related to 5-Fluorouracil Charkviani, Mariam Murvelashvili, Natia Barrera, Francisco Sharma, Alisha Eldin, Randa Sharag Nabil, Nur Un Nisa Case Rep Oncol Med Case Report 5-Fluorouracil (5-FU) is a chemotherapeutic agent frequently used for the treatment of solid tumors. In a few cases, 5-FU can be associated with coronary vasospasm, cardiac ischemia, or life-threatening arrhythmias. Recognition of 5-FU cardiotoxicity is clinically important as after the rapid sensation of therapy, cardiotoxicity can be completely reversible, and on the other hand, readministration may lead to serious damage of the heart and even death. A 70-year-old male came to the emergency department (ED) with chest pain which started while receiving an infusion of 5-FU. The patient did not have a personal history or risk factors of coronary artery disease and his electrocardiogram (ECG) before starting chemotherapy was completely normal. In the ED, his ECG had ischemic changes, troponin was elevated, and echocardiogram showed anterior wall hypokinesis. However, emergent coronary angiogram did not reveal any acute coronary occlusion. 5-FU-induced cardiotoxicity was suspected; the patient was admitted to a progressive care unit for close monitoring and infusion of calcium channel blockers was initiated. The patient's symptoms and ECG findings gradually resolved, and two days later on discharge, patient was chest pain free and ECG was normal. This case supports the vasospastic hypothesis of 5-FU cardiac toxicity, describes its clinical course, and emphasizes the importance of better awareness and early recognition of the rare side effect as it may allow physicians to reduce the risk of life-threatening complications. Hindawi 2020-07-20 /pmc/articles/PMC7391081/ /pubmed/32774961 http://dx.doi.org/10.1155/2020/4151474 Text en Copyright © 2020 Mariam Charkviani et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Charkviani, Mariam
Murvelashvili, Natia
Barrera, Francisco
Sharma, Alisha
Eldin, Randa Sharag
Nabil, Nur Un Nisa
Rare Presentation of Cardiotoxicity Related to 5-Fluorouracil
title Rare Presentation of Cardiotoxicity Related to 5-Fluorouracil
title_full Rare Presentation of Cardiotoxicity Related to 5-Fluorouracil
title_fullStr Rare Presentation of Cardiotoxicity Related to 5-Fluorouracil
title_full_unstemmed Rare Presentation of Cardiotoxicity Related to 5-Fluorouracil
title_short Rare Presentation of Cardiotoxicity Related to 5-Fluorouracil
title_sort rare presentation of cardiotoxicity related to 5-fluorouracil
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7391081/
https://www.ncbi.nlm.nih.gov/pubmed/32774961
http://dx.doi.org/10.1155/2020/4151474
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