Is 5-fluorouracil-induced vasospasm a Kounis syndrome? A diagnostic challenge

Karabay, CY; Gecmen, C; Aung, SM; Guler, A; Candan, O; Batgerel, U; Kalayci, A; Kirma, C
November 2011
Perfusion;Nov2011, Vol. 26 Issue 6, p542
Academic Journal
Cardiovascular hypersensitivity is a rare and well-documented side-effect of 5-FU (5-fluorouracil). Besides the common complications such as angina pectoris and myocardial infarction, it can also cause cardiogenic shock, and supraventricular and ventricular arrhythmias. Studies have reported that FU-induced angina most commonly occurred due to vasospasm. In our case, 9 hours after stopping the infusion of 5-FU, the patients developed symptoms and electrocardiographic (ECG) findings consistent with acute myocardial infarction. We intend to share this rare case and discuss whether this late complication after 5-FU infusion is an FU-induced vasospasm or rather an allergic reaction leading to Kounis syndrome.


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