Vasospastic angina caused by 5-fluorouracil. A case report.

The cardiotoxicity induced by 5-fluorouracil is mainly characterized by chest angina, associated with transient ST-segment elevation. It is assumed that the mechanisms of these ischemic findings could be related to the spasm of the coronary arteries. Most of these complications occur during the first administration. We present a case we consider relevant to prove that 5-fluorouracil might cause coronary spasm. Different cancers occur more often in elderly patients, who associate ischemic coronary disease also. We suggest that anti-ischaemic and coronary anti-spastic medication should be given from the very beginning in all patients with cancer, who need treatment with 5-fluorouracil. The specific medication used in oncology can lead to cardiovascular side effects, expressed by left ventricular dysfunction, different types of arrhythmias, and coronary ischemia, depending on the drug used [1]. The cardiotoxicity induced by 5-fluorouracil is mainly characterized by angina, usually associated with ST-segment elevation, and supraventricular arrhythmias [2-6]. It is assumed that the mechanisms of these ischemic symptoms could be caused by the spasm of the coronary vessels. It was also shown that most of these complications occur during the first cure. The incidence of the cardiac toxicity due to 5-fluorouracil was reported to range between 1.2% and 18% [7][8].