Acute Myocardial Infarction Following 5-Fluorouracil Use

Year 2019, Volume: 1 Issue: 2, 73 - 76, 17.07.2019

Şükrü Gürbüz , Muhammed Ekmekyapar , Hakan Oğuztürk Neslihan Yücel M. Gökhan Turtay , Serdar Derya

Abstract

Fluorouracil (5-FU) is the most common chemotherapeutic agent suggested for colorectal cancers. Cardiogenic side effects such as coroner artery vasospasm, ventricular dysrhythmia, and cardiac ischemia are also rarely stated. 48-year-old male patient applied to the emergency service with conditions of chest pain, nausea and vomiting. ECG was performed and found to be normal sinus rhythm. In the control ECG of the patient, there were ST elevations in inferior and anterior derivations. The control troponin value for the patient was found to be 0,073 μg/L (normal range 0,010-0.023 μg/L). When the patient expressed that his chest pain aggravated even more as he was being prepared for coroner angiography, control ECG was reperformed and seen that lateral derivations were added to ST elevations in inferior and anterior derivations. The patient, who has started to chemotherapy two days ago and still receives 5-FU infusion, is thought to have myocardial infarction with ST elevation based on the cardiotoxic impact of 5-FU, and he was taken to coroner angiography. His CAG is reported as LAD: Plaque CX: Plaque RCA: 40% lesion observed at CB alignment. 5-FU is a partner medical agent used to treat head and neck, gastrointestinal system, bladder, and chest malignancies. Despite cardiac toxicity being a rare and serious complication, the life-threatening toxicity is observed in 0,5% of the patients. In the previous reports, it is underlined that the only mechanism contributing to STEMI development after 5-FU infusion is vasospasm. In our case, the patient came to us with myocardial infarction with ST elevation resulting from the emergence of chest pain after the use of 5-FU. Patients should be closely followed when receiving 5-FU treatment. Due to the cardiac side effects that may seriously show a fatal course, patients should be examined in detail before the treatment.

Keywords

5-FU, chest pain, infarction

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