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Medline ® Abstract for Reference 73

of 'Fluoropyrimidine-associated cardiotoxicity: Incidence, clinical manifestations, mechanisms, and management'

5-Fluorouracil cardiotoxicity: left ventricular dysfunction and effect of coronary vasodilators.
Patel B, Kloner RA, Ensley J, Al-Sarraf M, Kish J, Wynne J
Am J Med Sci. 1987;294(4):238.
Seven patients developed clinical features simulating myocardial ischemia less than 72 hours after 12 of 13 separate intravenous 5-fluorouracil administrations; 9 episodes were associated with chest pain, 3 with hypotension, 3 with ventricular tachycardia and 1 with cardiogenic shock. Left ventricular dysfunction was demonstrated by echocardiography in 5 separate episodes, 2 with interval improvement upon repeat echocardiograms. Pretreatment with nitrates and/or calcium channel blockers failed to prevent recurrence of cardiotoxicity during 5 of 6 repeat 5-fluorouracil administrations. Therapy with 5-fluorouracil is associated with cardiotoxicity simulating myocardial ischemia with left ventricular dysfunction. Pretreatment with coronary vasodilators may not prevent this phenomenon.
Department of Internal Medicine, Wayne State University School of Medicine, Detroit, Michigan.