[Coronary artery stenting in the treatment of 5-fluorouracil-induced unstable angina].
Cardiotoxicity is a rare but very serious side effect of 5-fluorouracil (5-FU) treatment. Many theories have been suggested to explain the mechanism of this problem. Most commonly, coronary artery spasm is considered responsible in cardiovascular toxicity. Ischemic symptoms and signs related to 5-FU therapy are observed during the late phase of the administration of the drug. The close and careful monitoring of all patients, especially the ones with pre-existent coronary artery disease, during 5-FU infusion is mandatory. Because there is not a single and effective modality of prevention of 5-FU cardiotoxicity, the patients should be selected carefully for its administration, 5-FU infusion should be stopped as soon as symptoms are encountered. A case of a 58-year-old woman treated with 5-FU due to colon cancer is described. In the late phase of 5-FU administration, the patient developed anginal pain with transitional ST segment elevation in ECG. Patient, after coronary angiography, was successfully treated with percutaneous coronary intervention. Interventional methods, most of all stent implantation, seem to be the best treatment of 5-FU-related acute coronary syndromes.
Grześk
Grzegorz
G
Zakład Kardiologii Inwazyjnej Akademia Medyczna im. Ludwika Rydygiera w Bydgoszczy, ul. M. Skłodowskiej-Curie 9 85-094 Bydgoszcz. ggrzesk@amb.bydgoszcz.pl
Orzałkiewicz
Zbigniew
Z
Polak
Gwidon
G
Przybył
Romuald
R
Nartowicz
Edmund
E
Szadujkis-Szadurski
Leszek
L
Grabczewska
Zofia
Z
D000787:Angina Pectoris / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000628:therapy*; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D003110:Colonic Neoplasms / Q000188:drug therapy; D017023:Coronary Angiography; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004562:Electrocardiography; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects*; D006321:Heart / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D008875:Middle Aged; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil