An unusual case of acute myopericarditis after the first dose of capecitabine: Need for new cardioprotective strategies and risk stratification

Int J Clin Pharmacol Ther. 2021 Dec;59(12):775-779. doi: 10.5414/CP204006.

Abstract

Background: Fluoropyrimidines 5-fluorouracil (5-FU) and capecitabine are antimetabolite drugs used for the treatment of colorectal, breast, head, and neck malignancies. Different clinical manifestations of fluoropyrimidine-induced cardiotoxicity (FIC) have been reported in the literature.

Case report: A 46-year-old female patient with a history of colorectal adenocarcinoma presented to the Emergency Department due to chest pain and mildly elevated cardiac serum troponin levels. Three days earlier, she had received a first adjuvant chemotherapy treatment with oral capecitabine. After the exclusion of obstructive coronary artery disease (CAD), acute myopericarditis was suspected.

Conclusion: Capecitabine-induced myopericarditis is an extremely rare but important clinical condition to be recognized and treated promptly in order to prevent potentially lethal consequences of cardiac dysfunction.

Publication types

  • Case Reports

MeSH terms

  • Capecitabine / adverse effects
  • Cardiotoxicity
  • Female
  • Fluorouracil* / adverse effects
  • Heart Diseases*
  • Humans
  • Middle Aged
  • Risk Assessment

Substances

  • Capecitabine
  • Fluorouracil