Fluoropyrimidine Cardiotoxicity With Overlapping Vasospastic and Pericardial Features: A Diagnostic Challenge - PubMed
a day ago
- #cardiotoxicity
- #5-fluorouracil
- #pericarditis
- Fluoropyrimidines, such as 5-fluorouracil, are commonly used in gastrointestinal cancers but can cause cardiotoxicity, including coronary vasospasm and inflammatory pericardial involvement.
- A 57-year-old man with HER2-positive gastric cancer developed severe chest pain during a 5-FU infusion, showing ECG abnormalities like T-wave changes and QTc prolongation, but normal cardiac biomarkers and imaging initially.
- After 14 hours, the patient exhibited concave ST-segment elevation, and cardiac MRI indicated pericardial inflammation without myocardial necrosis, which resolved after discontinuing the drug and administering colchicine.
- This case highlights the complex, overlapping or sequential manifestations of 5-FU cardiotoxicity, including vasospastic, electrical, and inflammatory features, requiring a multidisciplinary approach for diagnosis and management.