5-fluorouracil can cause cardiotoxicity manifesting as myocardial ischemia, which may occur in the absence of underlying coronary disease.
5-FU cardiotoxicity may involve spasm without CAD; this case leaves open prospective studies on incidence and mechanisms.
Cardiotoxicity manifested as myocardial ischemia is not generally recognized as a side effect of 5-fluorouracil. However, there have been at least 35 cases reported since 1975. In only one of these cases was a somewhat detailed evaluation done to rule out underlying coronary disease. The case reported here of 5-FU cardiotoxicity included an extensive cardiac evaluation to rule out underlying coronary disease and to assess spasm. The literature on 5-FU cardiotoxicity is also reviewed, and its possible mechanisms are analyzed.
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Freeman et al. (1988) studied this question.
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