Mizuno Y, Hokamura Y, Kimura T, Kimura Y, Kaikita K, Yasue H
Division of Cardiology, Kumamoto Municipal Hospital, Japan.
Jpn Circ J. 1995 May;59(5):303-7. doi: 10.1253/jcj.59.303.
5-Fluorouracil (5-FU) is widely used in the treatment of various solid tumors. However, 5-FU cardiotoxicity is being reported with increasing frequency. The main symptom of cardiotoxicity is chest pain at rest with ischemic electrocardiographic changes. Up until now, the underlying mechanism has been suspected to be coronary artery spasm. However, this chest pain associated with 5-FU has several characteristics that are incompatible with coronary artery spasm; eg, inefficacy of calcium-channel blocker and a slow increase in cardiac enzyme levels. We experienced a case of 5-FU-induced cardiotoxicity which showed clinical findings consistent with acute myocardial infarction. Based on the clinical findings, coronary angiography, and left ventricular angiography in a prolonged attack, we concluded that the cardiotoxicity in this case was not due to ischemia caused by coronary artery spasm.
5-氟尿嘧啶（5-FU）广泛应用于各种实体瘤的治疗。然而，5-FU心脏毒性的报道频率日益增加。心脏毒性的主要症状是静息时胸痛伴缺血性心电图改变。到目前为止，其潜在机制一直被怀疑是冠状动脉痉挛。然而，这种与5-FU相关的胸痛有几个与冠状动脉痉挛不相符的特征；例如，钙通道阻滞剂无效以及心肌酶水平缓慢升高。我们遇到一例5-FU诱导的心脏毒性病例，其临床表现与急性心肌梗死一致。基于临床表现、冠状动脉造影以及长时间发作时的左心室造影，我们得出结论，该病例中的心脏毒性并非由冠状动脉痉挛导致的缺血引起。
