Cardiac Manifestations with Chemotherapeutic Agents: 5 Fluorouracil-Induced Coronary Artery Vasospasm  

作　　者：Vignendra Ariyarajah Mohamed S. Hameed Mohamed Firdaus M. Mydeen Guillermo J. Crespo Vignendra Ariyarajah;Mohamed S. Hameed;Mohamed Firdaus M. Mydeen;Guillermo J. Crespo(Division of Cardiology, Department of Medicine, Heart Care Consultants, New York, USA;Eastern Maine Inpatient Care, Eastern Maine Medical Center, Bangor, Maine;Department of Pathology, Dalhousie University, Halifax, Canada;Northeast Cardiology Associates, Eastern Maine Medical Center, Bangor, Maine)

机构地区：[1]Division of Cardiology, Department of Medicine, Heart Care Consultants, New York, USA [2]Eastern Maine Inpatient Care, Eastern Maine Medical Center, Bangor, Maine [3]Department of Pathology, Dalhousie University, Halifax, Canada [4]Northeast Cardiology Associates, Eastern Maine Medical Center, Bangor, Maine

出　　处：《World Journal of Cardiovascular Surgery》2023年第8期129-135,共7页心血管外科国际期刊（英文）

摘　　要：5-fluorouracil (5-FU) is a fluorinated, pyrimidine analog, antineoplastic agent that is used in the treatment of several solid organ cancers. Cardiotoxicity is uncommon but life-threatening manifestations such as myocardial infarction may manifest owing to 5-FU-induced coronary artery spasm. Administering smaller doses of the drug, more frequently than not, decreases the risk of cardiotoxicity compared to large doses or with continuous infusions. We present a case of ST-segment elevation in a patient without known coronary artery disease who had presented following continuous 5-FU infusion. Coronary angiogram confirmed absence of coronary artery disease and intravenous calcium channel blockers administration was commensurate with the patient’s improvement in symptoms. We discuss the literature on 5-FU and its association with coronary artery spasm, and also briefly review chemotherapy-induced cardiotoxicities to help better prepare internists and other primary health care providers to face similar challenges, particularly of the uncommon but potentially life-threatening manifestations.5-fluorouracil (5-FU) is a fluorinated, pyrimidine analog, antineoplastic agent that is used in the treatment of several solid organ cancers. Cardiotoxicity is uncommon but life-threatening manifestations such as myocardial infarction may manifest owing to 5-FU-induced coronary artery spasm. Administering smaller doses of the drug, more frequently than not, decreases the risk of cardiotoxicity compared to large doses or with continuous infusions. We present a case of ST-segment elevation in a patient without known coronary artery disease who had presented following continuous 5-FU infusion. Coronary angiogram confirmed absence of coronary artery disease and intravenous calcium channel blockers administration was commensurate with the patient’s improvement in symptoms. We discuss the literature on 5-FU and its association with coronary artery spasm, and also briefly review chemotherapy-induced cardiotoxicities to help better prepare internists and other primary health care providers to face similar challenges, particularly of the uncommon but potentially life-threatening manifestations.

关 键 词：5-FLUOROURACIL Chemotherapeutic Agent CARDIOTOXICITY VASOSPASM 

分 类 号：R54[医药卫生—心血管疾病]