Coronary Vasospasm Secondary to 5-Fluorouracil and Its Management: Case Report

• Main Authors: Mustafa Yildirim, Cem Parlak, Cem Sezer, Ramazan Eryilmaz, Cetin Kaya, Mustafa Yildiz
• Format: Article
• Language: English
• Published: AVES 2011-04-01
• Series: Eurasian Journal of Medicine
• Subjects: 5-fluorouracil; Coronary vasospasm; Diltiazem
• Online Access: http://www.eajm.org/text.php3?id=385

Although rare, 5-fluorouracil (5-FU) may lead to cardiotoxicity that presents with angina, elevated cardiac enzymes and electrocardiogram (ECG) changes. Coronary vasospasm related to 5-FU is a rare clinical entity in oncological practice and may be seen during both bolus and protracted infusional administration. This toxicity is generally reversible and responds well to conventional anti-angina treatment following discontinuation of infusion. We propose that parenteral diltiazem is an effective and safe approach for the treatment of coronary vasospasm secondary to 5-FU infusion. We present clinical findings and management of a case in which coronary vasospasm occurred during the infusion of the 5-FU component of FOLFIRI-bevacizumab chemotherapy (CT) regimen given for treatment of metastatic rectal cancer.