[Cardiotoxicity of 5-fluorouracil: coronary spasm? Apropos of 2 cases with normal coronarography].
Five fluoro-uracil (5-FU) is a cytotoxic drug which has been extensively used for chemotherapy since 1957. Ischaemic heart disease resulting from its administration is rare. Spontaneous angina during infusions of 5-FU was observed in two patients with electrocardiographic changes suggesting coronary spasm. After treatment, clinical examination, electrocardiogram, echocardiogram, stress test, coronary angiography with left ventriculography were all normal. An Ergonovine test was performed in one patient but failed to elicit coronary spasm. In the other patient, intravenous trinitrin and diltiazem were ineffective in preventing the ischaemic changes. A review of the literature is presented (51 cases). The pathophysiology of 5-FU-induced ischaemic heart disease is not fully understood. In 9 cases, coronary angiography was normal and coronary spasm was suggested as a possible cause. However, antispastic drugs are usually ineffective. It has been shown experimentally that 5-FU has a direct toxic effect on the myocardium.
Cristofini
P
P
Service de Cardiologie, Hôpital Boucicaut, Paris.
Desnos
M
M
Guenot
O
O
Funck
F
F
Hagege
A
A
Trotoux
J
J
Guerot
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003329:Coronary Vasospasm / Q000139:chemically induced* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects*; D006331:Heart Diseases / Q000139:chemically induced / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged
D005472:Fluorouracil
Cardiotoxicité du 5-fluoro-uracile: spasme coronaire? A propos de 2 observation avec coronarographie normale.