[Cerebral infarction and myocardial infarction due to cisplatin-containing chemotherapy].
A 33-year-old man was treated for a testicular non-seminoma carcinoma with three different chemotherapeutic agents: bleomycin, etoposide en cisplatin (BEP). During the second course of BEP he experienced two cerebral infarctions and a myocardial infarction at almost the same time. A CT-scan of the brain revealed a subcortical infarction in the left hemisphere. Angiography of the head and neck arteries revealed an almost completely thrombotic left carotid artery. ECG recordings showed signs of transmural ischaemia of the heart and an echocardiogram demonstrated irreversible myocardial damage. The time interval between the chemotherapy and the complications suggests a cisplatin-related cause (such adverse effects are unknown with bleomycin or etoposide). Cisplatin toxicity can give rise to serious vascular complications for which several factors appear to be responsible, such as an increased thrombogenicity and vascular spasm due to hypomagnesaemia.
Brouha
M E E
ME
Hart-Long-Instituut, afd. Cardiologie, Universitair Medisch Centrum Utrecht, Postbus 85.500, 3508 GA Utrecht. m.e.e.brough@hli.azu.nl
Bloemendal
H J
HJ
Kappelle
L J
LJ
Winter
J B
JB
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000627:therapeutic use; D002544:Cerebral Infarction / Q000139:chemically induced*; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000139:chemically induced*; D013736:Testicular Neoplasms / Q000188:drug therapy
D000970:Antineoplastic Agents; D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin