Spontaneous coronary artery dissection in a woman receiving 5-fluorouracil--a case report.
A 39-year-old woman with cervical cancer treated with pelvic radiation therapy and 5-fluorouracil (5-FU) was hospitalized for dehydration and intractable vomiting. She developed an acute ST-elevation myocardial infarction (MI) that extended electrocardiographically after thrombolytic therapy. Coronary angiography demonstrated a completely occluded left anterior descending (LAD) artery with extensive coronary dissection that was treated successfully with stenting. The authors discuss several factors that may have contributed to the spontaneous coronary artery dissection (SCAD) including chemotherapy-induced vasospasm, hemodynamic stress of vomiting, and hormonal changes associated with pelvic radiation.
Abbott
J Dawn
JD
Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT 06520-8017, USA.
Curtis
Jeptha P
JP
Murad
Khalil
K
Kramer
Harvey M
HM
Remetz
Michael S
MS
Setaro
John F
JF
Brennan
Joseph J
JJ
D000328:Adult; D000784:Aortic Dissection / Q000209:etiology*; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000209:etiology*; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects*; D006801:Humans
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil