Henry Danish, Rudzik Francine, Butts Allison, Mathew Aju
Markey Cancer Center, University of Kentucky, Lexington, Ky., USA.
Case Rep Oncol. 2016 Oct 17;9(3):629-632. doi: 10.1159/000450544. eCollection 2016 Sep-Dec.
Capecitabine, an oral prodrug of 5-fluorouracil (5-FU), is approved for early-stage and advanced colorectal cancer and metastatic breast cancer. Cardiotoxicity of 5-FU is well described in the literature. However, cardiac adverse effects of capecitabine are poorly described. We report a case of coronary vasospasm induced by capecitabine. A 41-year-old female with metastatic breast cancer presented with chest pain 3 days after starting capecitabine. The chest pain was relieved by rest and exacerbated by exertion. Her physical examination was unremarkable except for a rapid heart rate of 100 bpm. Electrocardiogram test showed no acute ischemic changes. Troponin tests were negative. CT angiography of the chest was negative for acute pulmonary embolism. An echocardiogram showed a left ventricular ejection fraction of 60% without any wall motion abnormalities. The chest pain resolved with aspirin and analgesic use. She was discharged following an inconclusive cardiac workup. Further use of capecitabine was discontinued.
卡培他滨是5-氟尿嘧啶（5-FU）的口服前体药物，已被批准用于早期和晚期结直肠癌以及转移性乳腺癌。5-FU的心脏毒性在文献中有充分描述。然而，卡培他滨的心脏不良反应描述较少。我们报告一例由卡培他滨引起的冠状动脉痉挛病例。一名41岁转移性乳腺癌女性在开始服用卡培他滨3天后出现胸痛。胸痛休息后缓解，劳累后加重。除心率快速（100次/分钟）外，她的体格检查无异常。心电图检查未显示急性缺血性改变。肌钙蛋白检测为阴性。胸部CT血管造影显示急性肺栓塞阴性。超声心动图显示左心室射血分数为60%，无任何室壁运动异常。胸痛经阿司匹林和止痛治疗后缓解。在心脏检查结果不明确后她出院了。卡培他滨的进一步使用被停用。
