[Acute coronary thrombosis and myocardial ischemia following chemotherapy of Hodgkin's disease].
A 37 year old man without coronary risk factors or known heart disease showed progression of Hodgkin's disease after radiation and multiple chemotherapy. One day after the first cycle of chemotherapy with methotrexate, Ifosfamide and etoposide, he had an acute myocardial ischemia. The creatinin-kinase was elevated up to 325 U/l. Coronary angiography showed a thrombus in the left anterior descending coronary artery (LAD), while the other coronary arteries were normal. Ventriculography showed an apical akinesia. After 7 days of treatment with heparin coronary angiogram was normalized, without any stenosis in the LAD. To our knowledge this is the first documented case of a coronary artery thrombosis and myocardial ischemia after chemotherapy in a patient without coronary heart disease. We conclude that chemotherapy can cause myocardial ischemia by coronary artery thrombosis in patients without prior heart disease.
II. Med. Klinik der Städt. Kliniken Kassel.
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Zeymer
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Neuhaus
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003327:Coronary Disease / Q000139:chemically induced*; D003328:Coronary Thrombosis / Q000139:chemically induced*; D005047:Etoposide / Q000009:adverse effects; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000532:radiotherapy; D006801:Humans; D007069:Ifosfamide / Q000009:adverse effects; D008297:Male; D008727:Methotrexate / Q000009:adverse effects; D009203:Myocardial Infarction / Q000139:chemically induced*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy
D005047:Etoposide; D007069:Ifosfamide; D008727:Methotrexate
Akute Koronarthrombose und Myokardischämie nach Chemotherapie bei Morbus Hodgkin.