Coronary artery diseaseCapecitabine-Induced Chest Pain Relieved by Diltiazem
Section snippets
Methods
Five patients with primary colorectal adenocarcinoma or anal squamous cell carcinoma and without histories of clinically significant coronary artery disease received capecitabine using a 2-weeks-on, 1-week-off schedule in addition to other chemotherapy and/or radiation (Table 1).
Results
Within the first several doses of capecitabine administered, all 5 patients experienced chest pain and/or dyspnea at rest or with exertion.
Patient 1 experienced typical angina during his initial capecitabine cycles, and the chest pain resolved between cycles; results of stress echocardiography were normal. Patient 2 underwent electrocardiography without evidence of acute ischemia during an episode of chest pain and subsequently had negative results on stress echocardiography. Patient 3
Discussion
To the best of our knowledge, this is the first report to describe successful retreatment with capecitabine in patients with suspected capecitabine-induced coronary vasospasm using prophylactic diltiazem.
There are several salient features of the clinical presentations that have been previously highlighted that merit further mention.10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22 First, our cohort was relatively young, had no known histories of coronary artery disease, and had normal results
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The Incidence, Risk Factors, and Outcomes With 5-Fluorouracil–Associated Coronary Vasospasm
2021, JACC: CardioOncologyCitation Excerpt :Thus, it is possible that studies that define 5-FU cardiotoxicity solely on the basis of chest pain symptoms could miss patients with silent ischemic changes and thus underestimate the incidence of 5-FU cardiotoxicity. Our findings of a lower age and reduced rates of cardiovascular risk factors are consistent with the findings of Ambrosy et al. (14), who showed that in a case series of 5 patients who had capecitabine-induced coronary vasospasm, the mean age was 58.6 years, and none of the patients had a history of coronary artery disease. Similarly, Chakrabarti et al. (15) published a retrospective review of patients who received infusional 5-FU (FOLFOX and CAPOX regimens) at the Mayo Clinic from January 2011 to January 2018 and identified 10 patients who developed coronary vasospasm.
Myocardial Ischemia and Cancer Therapy
2017, Cardio-Oncology: Principles, Prevention and ManagementCardiac arrest and ventricular fibrillation in a young man treated with capecitabine: Case report and literature review
2016, International Journal of CardiologyA Rare Cause and Management of Ventricular Fibrillation: 5-Fluorouracil Toxicity
2024, Arquivos Brasileiros de Cardiologia