5-Fluorouracil cardiotoxicity: reversible left ventricular systolic dysfunction with early detection.
A 33-year-old man presented to hospital with acute shortness of breath and evolving ST segment changes on ECG 3 days following a cycle of 5-fluorouracil (5-FU) for colon cancer. Despite no cardiac history, subsequent echocardiogram showed severe left ventricular systolic dysfunction. The patient was initially treated with heart failure medications and his coronary angiogram was normal. Chemotherapy was stopped and he was started on nitrates and calcium channel blockers. A repeat echocardiogram and cardiac MRI a week later showed complete resolution of his left ventricular dysfunction and he was discharged home. This case report summarises 5-FU cardiotoxicity, and emphasises the importance of early recognition and correct treatment, as left ventricular systolic dysfunction in this context is potentially reversible.
Department of Cardiology, Ninewells Hospital, Dundee, UK.
Muhammad Zaid
MZ
Iskandar
Department of Acute Medicine, Manchester Royal Infirmary, Manchester, UK.
Wahid
W
Quasem
Department of Cardiology, Manchester Royal Infirmary, Manchester, UK.
Magdi
M
El-Omar
D000328:Adult; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D066126:Cardiotoxicity / Q000209:etiology; D003110:Colonic Neoplasms / Q000188:drug therapy; D017023:Coronary Angiography; D004452:Echocardiography; D004562:Electrocardiography; D005472:Fluorouracil / Q000009:adverse effects* / Q000627:therapeutic use; D006352:Heart Ventricles / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009566:Nitrates / Q000627:therapeutic use; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy / Q000209:etiology*
D000964:Antimetabolites, Antineoplastic; D002121:Calcium Channel Blockers; D009566:Nitrates; D005472:Fluorouracil