What the Cardiologist Needs to Consider in the Management of Oncologic Patients with STEMI-Like Syndrome: A Case Report and Literature Review.
Aneta AleksovaGiulia GagnoAlessandro PierriCarla TodaroAlessandra Lucia FlucaValentina OrlandoAlessandra GuglielmiAntonio Paolo BeltramiGianfranco SinagraPublished in: Pharmaceuticals (Basel, Switzerland) (2021)
In pre-hospital care, an accurate and quick diagnosis of ST-segment elevation myocardial infarction (STEMI) is imperative to promptly kick-off the STEMI network with a direct transfer to the cardiac catheterization laboratory (cath lab) in order to reduce myocardial infarction size and mortality. Aa atherosclerotic plaque rupture is the main mechanism responsible for STEMI. However, in a small percentage of patients, emergency coronarography does not reveal any significant coronary stenosis. The fluoropyrimidine agents such as 5-Fluorouracil (5-FU) and capecitabine, widely used to treat gastrointestinal, breast, head and neck cancers, either as a single agent or in combination with other chemotherapies, can cause potentially lethal cardiac side effects. Here, we present the case of a patient with 5-FU cardiotoxicity resulting in an acute coronary syndrome (ACS) with recurrent episodes of chest pain and ST-segment elevation.. Our case report highlights the importance of widening the knowledge among cardiologists of the side effects of chemotherapeutic drugs, especially considering the rising number of cancer patients around the world and that fluoropyrimidines are the main treatment for many types of cancer, both in adjuvant and advanced settings.
Keyphrases
- st segment elevation myocardial infarction
- percutaneous coronary intervention
- acute coronary syndrome
- case report
- coronary artery disease
- st elevation myocardial infarction
- antiplatelet therapy
- healthcare
- left ventricular
- end stage renal disease
- cardiovascular events
- public health
- coronary artery
- early stage
- ejection fraction
- palliative care
- heart failure
- chronic kidney disease
- prostate cancer
- prognostic factors
- atrial fibrillation
- squamous cell carcinoma
- risk factors
- peritoneal dialysis
- genome wide
- quality improvement
- high resolution
- pain management
- clinical trial
- combination therapy
- phase ii study
- ultrasound guided
- type diabetes
- phase iii
- metastatic breast cancer
- young adults
- drug induced
- chronic pain
- dna methylation
- patient reported
- robot assisted
- transcatheter aortic valve replacement
- cardiovascular disease