Abstract
A 38-year-old man with a colonic carcinoma experienced cardiogenic shock during continuous intravenous treatement with 5-fluorouracil (5-FU), without clinical or electrical sings of coronary insufficiency and with a normal coronary angiogram. His symptoms resolved after eight days of inotropic and vasoldilator therapy. Because of the severity of the shock, rechallenge was not performed. This is the first case of acute cardiac failure without coronary ischemia, associated with 5-FU monotherapy. Experimental studies suggest that this adverse effect could be due to myocardial accumulation of 5-FU leading to depletion of high energy phosphate compounds. This might also explain the more frequently seen acute coronary insufficiency due to 5-FU.
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Misset, B., Escudier, B., Leclercq, B. et al. Acute myocardiotoxicity during 5-fluorouracil therapy. Intensive Care Med 16, 210–211 (1990). https://doi.org/10.1007/BF01724805
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DOI: https://doi.org/10.1007/BF01724805