5-Fluorouracil cardiotoxicity: left ventricular dysfunction and effect of coronary vasodilators.
Seven patients developed clinical features simulating myocardial ischemia less than 72 hours after 12 of 13 separate intravenous 5-fluorouracil administrations; 9 episodes were associated with chest pain, 3 with hypotension, 3 with ventricular tachycardia and 1 with cardiogenic shock. Left ventricular dysfunction was demonstrated by echocardiography in 5 separate episodes, 2 with interval improvement upon repeat echocardiograms. Pretreatment with nitrates and/or calcium channel blockers failed to prevent recurrence of cardiotoxicity during 5 of 6 repeat 5-fluorouracil administrations. Therapy with 5-fluorouracil is associated with cardiotoxicity simulating myocardial ischemia with left ventricular dysfunction. Pretreatment with coronary vasodilators may not prevent this phenomenon.
Patel
B
B
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan.
Kloner
R A
RA
Ensley
J
J
Al-Sarraf
M
M
Kish
J
J
Wynne
J
J
D000368:Aged; D003327:Coronary Disease / Q000139:chemically induced* / Q000503:physiopathology / Q000517:prevention & control; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects*; D006321:Heart / Q000187:drug effects* / Q000503:physiopathology; D006352:Heart Ventricles / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014665:Vasodilator Agents / Q000627:therapeutic use*
D014665:Vasodilator Agents; D005472:Fluorouracil