A case of cardiogenic shock caused by capecitabine treatment.
BACKGROUND
A 52-year-old woman underwent successful resection of stage IIB primary mucinous adenocarcinoma of the appendix and was started on capecitabine chemotherapy. Five days into the first course, after initially experiencing diarrhea, nausea, vomiting and a transient episode of retrosternal chest pain radiating to the left scapula, she presented to the emergency department with cardiogenic shock.


METHODS
Electrocardiography, transthoracic echocardiography, laboratory investigation of cardiac biomarkers, coronary angiography and endomyocardial biopsy.


METHODS
Capecitabine-induced cardiogenic shock.


RESULTS
Supportive treatment with dopamine, milrinone, norepinephrine (noradrenaline) and levosimendan.
To
Andrew C Y
AC
Green Lane Cardiovascular Service, Auckland City Hospital, Park Road, Grafton, Auckland 1023, New Zealand. andrewcyto@gmail.com
Looi
Khang Li
KL
Damianovich
Dragan
D
Taylor
Graeme B
GB
Sidebotham
David
D
White
Harvey D
HD
D002288:Adenocarcinoma, Mucinous / Q000188:drug therapy* / Q000601:surgery; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D001063:Appendiceal Neoplasms / Q000188:drug therapy* / Q000601:surgery; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D000069287:Capecitabine; D002316:Cardiotonic Agents / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D017023:Coronary Angiography; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D008875:Middle Aged; D012770:Shock, Cardiogenic / Q000139:chemically induced* / Q000188:drug therapy / Q000473:pathology; D016896:Treatment Outcome
D000964:Antimetabolites, Antineoplastic; D015415:Biomarkers; D002316:Cardiotonic Agents; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil