Key result
Mechanical circulatory support successfully bridges 5-fluorouracil-induced toxic cardiomyopathy and cardiogenic shock to recovery.
Why the study?
Cardiogenic shock is a rare adverse event of 5-fluorouracil administration with limited knowledge about its epidemiologic and clinical features and no specific treatment recommendations.
Case Report (n=1)
Mechanical circulatory support such as VA-ECMO and Impella can be successfully used as a bridge to recovery in patients with 5-FU-induced cardiogenic shock.
Background: Cardiogenic shock is a rare adverse event of 5-fluorouracil (5-FU) administration. Because of its rare entity, little is known about epidemiologic and clinical features of 5-FU-induced cardiogenic shock, and recommendations about specific treatment are missing. Case summary: We present a case of cardiogenic shock and ventricular arrhythmia due to 5-FU-induced toxic cardiomyopathy treated with vasopressor and inotropic drugs in combination with intra-aortic balloon pump. Because of persistent haemodynamic instability, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and Impella were implanted as a bridge to recovery. Systolic function recovered completely and the patient was weaned successfully. Discussion: This case demonstrates toxic cardiomyopathy as a rare and potentially lethal cardiac adverse event of 5-FU administration. This case emphasizes the importance of mechanical support as bridging therapy to recovery of cardiac function.
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Vanoverbeke et al. (2023) conducted a case report in Cardiogenic shock due to 5-fluorouracil-induced toxic cardiomyopathy (n=1). 5-fluorouracil (5-FU) was evaluated on Cardiogenic shock and recovery of systolic function. 5-fluorouracil administration can cause potentially lethal toxic cardiomyopathy and cardiogenic shock, which was successfully managed with mechanical support as a bridge to recovery.
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