Coronary artery spasm induced by 5-fluorouracil

• Published in: Clinical research in cardiology Vol. 94; no. 1; pp. 33 - 37
• Main Authors: Alter, P, Herzum, M, Schaefer, J R, Maisch, B
• Format: Journal Article
• Language: English
• Published: Germany Springer Nature B.V 01.01.2005
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - surgery; Aged; Angina pectoris; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - toxicity; Cardiovascular disease; Cisplatin - administration & dosage; Cisplatin - toxicity; Coronary Angiography; Coronary Circulation - drug effects; Coronary Vasospasm - chemically induced; Coronary Vasospasm - diagnostic imaging; Coronary vessels; Electrocardiography - drug effects; Esophageal Neoplasms - drug therapy; Esophageal Neoplasms - surgery; Esophagectomy; Exercise Test - drug effects; Fluorouracil - administration & dosage; Fluorouracil - toxicity; Heart attacks; Humans; Leucovorin - administration & dosage; Leucovorin - toxicity; Male; Neoadjuvant Therapy - adverse effects; Nitrates; Regional Blood Flow - drug effects
• ISSN: 0300-5860; 1861-0684; 1435-1285; 1861-0692
• DOI: 10.1007/s00392-005-0159-8

The frequently used chemotherapeutic drug 5-fluorouracil (5-FU) is known to cause angina pectoris and arrhythmias; myocardial infarction and sudden cardiac death could occur. Potential reasons for these phenomena range from toxic/metabolic disturbances to coronary artery spasms. This report shows angiographically proven spasmophilia of the coronary arteries and contributes to the understanding of angina pectoris occurring during treatment with 5-FU. Thus, verapamil type calcium antagonists as well as nitrates should be administered primarily in patients with coronary artery disease and in all patients who had been symptomatic during 5-FU administration in order to prevent further episodes.