• Laura K Shoemaker, Umesh Arora, and Caio M Rocha Lima.
• Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, USA. laurakshoemaker@yahoo.com
• Cancer Control. 2004 Jan 1; 11 (1): 46-9.

BackgroundCardiotoxicity is a rare but well-documented adverse effect of 5-fluorouracil (5-FU). The underlying cause of this side effect of 5-FU is uncertain.MethodsWe present a case report of a 63-year-old man treated for metastatic colon cancer who experienced chest pain while being treated with the FOLFIRI regimen. This case report documents coronary artery spasm on catheterization observed with the continuous infusion of 5-FU.ResultsCardiac catheterization obtained within 36 hours of the onset of chest pain revealed marked coronary vasospasm in the obtuse marginal coronary artery and a right coronary artery with a critical obstructive atherosclerotic plaque. Electrocardiogram revealed the myocardium area associated with the event was diffuse rather than localized to the right coronary artery.ConclusionsThis observation supports the vasospastic hypothesis for 5-FU-induced angina. Although rare, this type of cardiotoxicity with 5-FU is a potentially lethal side effect. Therapy with 5-FU should be discontinued and patients should be promptly treated.

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