Various Manifestations of 5-Fluorouracil Cardiotoxicity: A Multicenter Case Series and Review of Literature

Cardiovasc Toxicol. 2020 Aug;20(4):437-442. doi: 10.1007/s12012-020-09562-w.

Abstract

5-Fluorouracil is a key element to the treatment of colon cancer. But it is also one of the most cardiotoxic chemotherapies, and the management of those that experience cardiotoxicity can be challenging. We present three cases of 5-FU cardiac toxicity that manifested as myocardial infarction, cardiogenic shock, and ventricular fibrillation. Additionally, we discuss the current literature regarding 5-fluorouracil cardiotoxicity mechanisms as well as management.

Keywords: 5-Fluorouracil; Acute myocardial infarction; Arrhythmia; Cardiogenic shock; Cardiotoxicity; Chemotherapy; Colon cancer; Pharmacotherapy; Ventricular fibrillation.

Publication types

  • Case Reports
  • Multicenter Study
  • Review

MeSH terms

  • Adult
  • Antimetabolites, Antineoplastic / adverse effects*
  • Cardiotoxicity
  • Colonic Neoplasms / drug therapy*
  • Disease Progression
  • Electrocardiography
  • Fatal Outcome
  • Female
  • Fluorouracil / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Non-ST Elevated Myocardial Infarction / chemically induced*
  • Non-ST Elevated Myocardial Infarction / diagnosis
  • Shock, Cardiogenic / chemically induced*
  • Shock, Cardiogenic / diagnosis
  • Ventricular Fibrillation / chemically induced*
  • Ventricular Fibrillation / diagnosis

Substances

  • Antimetabolites, Antineoplastic
  • Fluorouracil