The syndrome of 5-fluorouracil cardiotoxicity. An elusive cardiopathy.
BACKGROUND
A case of reversible cardiogenic shock linked to 5-fluorouracil (5-FU) was observed. Recognizing the increasing use of 5-FU, the authors tried to map this syndrome.


METHODS
They reviewed 134 additional case reports, retrieved information from literature searches, focused on clinical features, and discussed possible pathophysiologic findings and prevention of this syndrome.


RESULTS
Although angina and electrocardiographic changes were common and reproducible (approximately 90% each), coronary artery disease was found in a few patients. A total of 33 patients had severe left ventricular dysfunction, 28 without evidence of myocardial infarction. The symptoms were responsive to conservative management (90%).


CONCLUSIONS
Cardiac toxicity is a little known complication of 5-FU therapy, with an unknown but significant incidence. It is highly treatable.
Robben
N C
NC
Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710.
Pippas
A W
AW
Moore
J O
JO
D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects*; D006331:Heart Diseases / Q000139:chemically induced*; D006801:Humans; D008875:Middle Aged; D011743:Pyrimidines / Q000378:metabolism; D013577:Syndrome
D011743:Pyrimidines; C030986:pyrimidine; D005472:Fluorouracil