Symptoms and signs of an acute myocardial ischemia caused by chemotherapy with Paclitaxel (Taxol) in a patient with metastatic ovarian carcinoma.
BACKGROUND
Paclitaxel (Taxol) is an anticancer agent used for the treatment of breast and ovarian cancer. The major side effects are bone marrow suppression, alopecia, polyneuropathy and cardiac toxicity like bradycardia, myocardial infarction, congestive heart failure and cardiac death.


METHODS
Intensive care unit (ICU) of a university hospital.


METHODS
We report on a 58-years-old woman with a metastatic ovarian carcinoma who had chest pain, nausea and collapse during their first Taxol infusion. The infusion was stopped and the patient was submitted to the intensive care unit (ICU) to exclude an acute coronary syndrome.


RESULTS
The electrocardiography (ECG) showed a third-degree heart block and ST elevation in II, III and avF. In the initial and in the control laboratory investigation values of cardiac enzymes (creatininkinase and Troponine T) remained normal. The control ECG after 30 minutes turned back to normal. After one day the patient was submitted back to a normal ward.


CONCLUSIONS
Symptomatic bradyarrhythmia and clinical sign of an myocardial infarction are rare but important cardiac side effects in patients treated with Taxol. Those patients should be under intensive care unit until patients conditions improve and acute myocardial ischemia has been excluded.
Schrader
Carsten
C
2nd Department of Internal Medicine, University Hospital of Schleswig-Holstein, Kiel, Chemnitzstrasse 33, D-24116 Kiel, Germany. c.schrader@med2.uni-kiel.de
Keussen
C
C
Bewig
B
B
von Freier
A
A
Lins
M
M
D000208:Acute Disease; D000787:Angina Pectoris / Q000139:chemically induced; D000925:Anticoagulants / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects*; D001919:Bradycardia / Q000139:chemically induced; D002277:Carcinoma / Q000188:drug therapy* / Q000473:pathology; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000139:chemically induced* / Q000503:physiopathology*; D009325:Nausea / Q000139:chemically induced; D009362:Neoplasm Metastasis / Q000188:drug therapy / Q000473:pathology; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects*; D016896:Treatment Outcome
D000925:Anticoagulants; D000972:Antineoplastic Agents, Phytogenic; D006493:Heparin; D017239:Paclitaxel