title: Takotsubo cardiomyopathy and 5-Fluorouracil: getting to the heart of the matter.
abstract: Takotsubo cardiomyopathy is a rare but increasingly recognized phenomenon, which can occur as a side-effect of chemotherapeutic agents, in particular, the antimetabolite 5-fluorouracil. We describe a case of delayed Takotsubo cardiomyopathy after 3 weeks of adjuvant 5-fluorouracil for resected rectal adenocarcinoma in a 66-year-old female, supported by angiographic, electrocardiographic, and echocardiographic features. As a complication, she developed an apical mural thrombus with subsequent cerebral thromboembolic events and was successfully anticoagulated to make a full recovery. We present a review of the literature on Takotsubo cardiomyopathy secondary to 5-fluorouracil and the rare occurrence of thromboembolic complications. As this is a significant clinical phenomenon which involves a multispeciality approach to management, oncologists and cardiologists need to recognize it as a potential toxicity of a widely administered chemotherapeutic drug.
authors.affiliation: Department of Medical Oncology, Liverpool Hospital, Elizabeth Street, Liverpool, NSW 2170, Australia ; Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia ; University of New South Wales, Kensington, NSW 2033, Australia.
authors.forename: Stephanie Hui-Su
authors.initials: SH
authors.lastname: Lim
authors.affiliation: Department of Cardiology, St George Hospital, Kogarah, NSW 2217, Australia.
authors.forename: Sharon Mary
authors.initials: SM
authors.lastname: Wilson
authors.affiliation: Department of Cardiology, Wagga Wagga Base Hospital, Wagga Wagga, NSW 2650, Australia.
authors.forename: Arnagretta
authors.initials: A
authors.lastname: Hunter
authors.affiliation: Riverina Cancer Care Centre, Wagga Wagga, NSW 2650, Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Hill
authors.affiliation: Concord Repatriation General Hospital, Concord West, NSW 2138, Australia.
authors.forename: Philip
authors.initials: P
authors.lastname: Beale