What does this research mean for the field?

Cisplatin and capecitabine chemotherapy can induce cardiotoxic effects, such as vasospasm, that may lead to spontaneous coronary artery dissection. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

July 11, 2019Annals of Medicine and SurgeryOpen Access

Spontaneous coronary artery dissection during cisplatin and capecitabine therapy

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Why the study?

The mechanism and optimal treatment of spontaneous coronary artery dissection are not fully understood.

Structured PICO

Population

55-year-old woman with rectal adenocarcinoma

Intervention

Cisplatin and capecitabine therapy

Outcome

Spontaneous coronary artery dissection and acute myocardial infarctionsafety

Highlights the potential for cisplatin and capecitabine therapy to cause spontaneous coronary artery dissection and acute myocardial infarction.

Implication

Alerts clinicians to possible SCAD during cisplatin-capecitabine chemotherapy; hypothesis-generating case that leaves causal link open.

Abstract

INTRODUCTION: Spontaneous coronary artery dissection is a rare cardiovascular disease that can cause acute myocardial infarction and sudden cardiac death. The mechanism of this pathology and the optimal treatment are not fully understood. PRESENTATION OF CASE: An acute myocardial infarction developed while a fifty five years old woman with a rectal adenocarcinoma was receiving a cisplatin and capecitabine therapy. Coronary angiography demonstrated a multivessel occlusion of coronary arteries. DISCUSSION: The authors discuss several factors that may lead to the spontaneous coronary artery dissection including chemotherapy-induced vasospasm. Chemotherapy based on the cisplatin and capecitabine intake can cause a cardiotoxic effect. CONCLUSION: Thus, spontaneous coronary artery dissection is a disease with an extremely complex etiololy, which does not have a special treatment guide. Management should be considered individually for each case.