Iskandar Muhammad Zaid, Quasem Wahid, El-Omar Magdi
Department of Cardiology, Ninewells Hospital, Dundee, UK.
Department of Acute Medicine, Manchester Royal Infirmary, Manchester, UK.
BMJ Case Rep. 2015 May 2;2015:bcr2015209347. doi: 10.1136/bcr-2015-209347.
A 33-year-old man presented to hospital with acute shortness of breath and evolving ST segment changes on ECG 3 days following a cycle of 5-fluorouracil (5-FU) for colon cancer. Despite no cardiac history, subsequent echocardiogram showed severe left ventricular systolic dysfunction. The patient was initially treated with heart failure medications and his coronary angiogram was normal. Chemotherapy was stopped and he was started on nitrates and calcium channel blockers. A repeat echocardiogram and cardiac MRI a week later showed complete resolution of his left ventricular dysfunction and he was discharged home. This case report summarises 5-FU cardiotoxicity, and emphasises the importance of early recognition and correct treatment, as left ventricular systolic dysfunction in this context is potentially reversible.
一名33岁男性因结肠癌接受5-氟尿嘧啶（5-FU）化疗周期3天后，出现急性呼吸急促，心电图显示ST段改变逐渐加重，遂入院治疗。尽管既往无心脏病史，但随后的超声心动图显示严重的左心室收缩功能障碍。患者最初接受心力衰竭药物治疗，冠状动脉造影正常。化疗停止，开始使用硝酸盐和钙通道阻滞剂。一周后复查超声心动图和心脏磁共振成像显示左心室功能障碍完全恢复，患者出院回家。本病例报告总结了5-FU心脏毒性，并强调早期识别和正确治疗的重要性，因为在这种情况下左心室收缩功能障碍可能是可逆的。
