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Case Reports
. 1990 Jul;5(2):112-7.
doi: 10.3904/kjim.1990.5.2.112.

Electrocardiographic changes simulating acute myocardial infarction or ischemia associated with combination chemotherapy with etoposide, cisplatin, and 5-fluorouracil

K H Lee  1 , J S Lee, S H Kim
Affiliations
Case Reports

Electrocardiographic changes simulating acute myocardial infarction or ischemia associated with combination chemotherapy with etoposide, cisplatin, and 5-fluorouracil

K H Lee et al. Korean J Intern Med. 1990 Jul.

Abstract

Three cases of cardiotoxicity manifested by chest pain, tachycardia, respiratory distress, and electrocardiographic changes simulating acute myocardial infarction or ischemia were observed during the course of combination chemotherapy with etoposide, cisplatin, and continuous infusion of 5-fluorouracil in patients with advanced non-small cell lung cancer. There was no cardiac enzyme elevation. A similar but rare clinical syndrome has been described in association with 5-fluorouracil infusion as a single agent or in combination with other chemotherapeutic agents. We describe the cases and review their possible pathogeneses and clinical implications.

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Figures

Fig. 1.
Fig. 1.
Initial EKG (A) shows ST segment elevation in the precordial leads and further change 2 days later (B).
Fig. 2.
Fig. 2.
Prechemotherapy EKG (A) and EKG at the time of chest pain (B) which shows ST segment elevation and T wave inversion precordially, and EKG 3 months later (C) which shows persistent ST-T changes.
Fig. 3.
Fig. 3.
Prechemotherapy EKG (A) and EKG during chemotherapy (B) which shows ST elevation in leads II and III and ST depression in the precordial leads.
See this image and copyright information in PMC

References

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