title: Is 5-fluorouracil-induced vasospasm a Kounis syndrome? A diagnostic challenge.
abstract: Cardiovascular hypersensitivity is a rare and well-documented side-effect of 5-FU (5-fluorouracil). Besides the common complications such as angina pectoris and myocardial infarction, it can also cause cardiogenic shock, and supraventricular and ventricular arrhythmias. Studies have reported that FU-induced angina most commonly occurred due to vasospasm. In our case, 9 hours after stopping the infusion of 5-FU, the patients developed symptoms and electrocardiographic (ECG) findings consistent with acute myocardial infarction. We intend to share this rare case and discuss whether this late complication after 5-FU infusion is an FU-induced vasospasm or rather an allergic reaction leading to Kounis syndrome.
authors.affiliation: Kartal Koşuyolu Heart & Research Hospital, Cardiology Clinic, Istanbul, Turkey. karabaymd@yahoo.com
authors.forename: C Y
authors.initials: CY
authors.lastname: Karabay
authors.forename: C
authors.initials: C
authors.lastname: Gecmen
authors.forename: S M
authors.initials: SM
authors.lastname: Aung
authors.forename: A
authors.initials: A
authors.lastname: Guler
authors.forename: O
authors.initials: O
authors.lastname: Candan
authors.forename: U
authors.initials: U
authors.lastname: Batgerel
authors.forename: A
authors.initials: A
authors.lastname: Kalayci
authors.forename: C
authors.initials: C
authors.lastname: Kirma
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D018279:Carcinoma, Signet Ring Cell / Q000188:drug therapy*; D003329:Coronary Vasospasm / Q000209:etiology*; D004562:Electrocardiography; D005472:Fluorouracil / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology*
chemical_list: D000964:Antimetabolites, Antineoplastic; D007166:Immunosuppressive Agents; D005472:Fluorouracil