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S1-induced vasospastic angina—diagnostic utility of Holter ECG: a report of a case

BACKGROUND: Vasospastic angina is a rare but potentially life-threatening adverse event (AE) of S1, an oral fluoropyrimidine anticancer agent. However, this AE is not well known owing to its low incidence. We report herein a case of a patient who suffered from vasospastic angina associated with S1 c...

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Autores principales: Kanda, Tatsuo, Wakai, Atsuhiro, Chida, Tadasu, Nakamura, Yuichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7445223/
https://www.ncbi.nlm.nih.gov/pubmed/32833093
http://dx.doi.org/10.1186/s40792-020-00975-x
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author Kanda, Tatsuo
Wakai, Atsuhiro
Chida, Tadasu
Nakamura, Yuichi
author_facet Kanda, Tatsuo
Wakai, Atsuhiro
Chida, Tadasu
Nakamura, Yuichi
author_sort Kanda, Tatsuo
collection PubMed
description BACKGROUND: Vasospastic angina is a rare but potentially life-threatening adverse event (AE) of S1, an oral fluoropyrimidine anticancer agent. However, this AE is not well known owing to its low incidence. We report herein a case of a patient who suffered from vasospastic angina associated with S1 chemotherapy for unresectable gastric adenocarcinoma, along with a review of the literature. CASE PRESENTATION: A 68-year-old woman was endoscopically diagnosed with gastric adenocarcinoma of the diffuse type. Abdominal pelvic contrast-enhanced computed tomography (CT) revealed small nodules in the omentum and ascites in the pouch of Douglas. The patient was clinically diagnosed with unresectable gastric adenocarcinoma with peritoneal metastasis, and primary chemotherapy with S1 plus cisplatin was selected. Around midnight of day 1, the patient complained of sudden oppressive chest pain. The pain disappeared spontaneously after 3–5 min, but similar events happened every midnight thereafter. No significant change was found on bedside electrocardiograms (ECGs) recorded immediately after the pain attacks. The patient was suspected to have unstable angina and underwent Holter ECG on day 4 of treatment. Holter ECG revealed ST segment elevations and short-run ventricular tachycardia during a pain attack. S1 chemotherapy was discontinued, and no attack was observed thereafter. Coronary CT angiography showed no significant stenosis of coronary arteries. CONCLUSIONS: Clinicians should be aware of vasospastic angina as a serious AE in the chemotherapy with S1. Holter ECG is useful for the early diagnosis of this rare and clinically important AE.
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spelling pubmed-74452232020-09-02 S1-induced vasospastic angina—diagnostic utility of Holter ECG: a report of a case Kanda, Tatsuo Wakai, Atsuhiro Chida, Tadasu Nakamura, Yuichi Surg Case Rep Case Report BACKGROUND: Vasospastic angina is a rare but potentially life-threatening adverse event (AE) of S1, an oral fluoropyrimidine anticancer agent. However, this AE is not well known owing to its low incidence. We report herein a case of a patient who suffered from vasospastic angina associated with S1 chemotherapy for unresectable gastric adenocarcinoma, along with a review of the literature. CASE PRESENTATION: A 68-year-old woman was endoscopically diagnosed with gastric adenocarcinoma of the diffuse type. Abdominal pelvic contrast-enhanced computed tomography (CT) revealed small nodules in the omentum and ascites in the pouch of Douglas. The patient was clinically diagnosed with unresectable gastric adenocarcinoma with peritoneal metastasis, and primary chemotherapy with S1 plus cisplatin was selected. Around midnight of day 1, the patient complained of sudden oppressive chest pain. The pain disappeared spontaneously after 3–5 min, but similar events happened every midnight thereafter. No significant change was found on bedside electrocardiograms (ECGs) recorded immediately after the pain attacks. The patient was suspected to have unstable angina and underwent Holter ECG on day 4 of treatment. Holter ECG revealed ST segment elevations and short-run ventricular tachycardia during a pain attack. S1 chemotherapy was discontinued, and no attack was observed thereafter. Coronary CT angiography showed no significant stenosis of coronary arteries. CONCLUSIONS: Clinicians should be aware of vasospastic angina as a serious AE in the chemotherapy with S1. Holter ECG is useful for the early diagnosis of this rare and clinically important AE. Springer Berlin Heidelberg 2020-08-24 /pmc/articles/PMC7445223/ /pubmed/32833093 http://dx.doi.org/10.1186/s40792-020-00975-x Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Case Report
Kanda, Tatsuo
Wakai, Atsuhiro
Chida, Tadasu
Nakamura, Yuichi
S1-induced vasospastic angina—diagnostic utility of Holter ECG: a report of a case
title S1-induced vasospastic angina—diagnostic utility of Holter ECG: a report of a case
title_full S1-induced vasospastic angina—diagnostic utility of Holter ECG: a report of a case
title_fullStr S1-induced vasospastic angina—diagnostic utility of Holter ECG: a report of a case
title_full_unstemmed S1-induced vasospastic angina—diagnostic utility of Holter ECG: a report of a case
title_short S1-induced vasospastic angina—diagnostic utility of Holter ECG: a report of a case
title_sort s1-induced vasospastic angina—diagnostic utility of holter ecg: a report of a case
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7445223/
https://www.ncbi.nlm.nih.gov/pubmed/32833093
http://dx.doi.org/10.1186/s40792-020-00975-x
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