Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2025 Apr 8;17(4):e81890.
doi: 10.7759/cureus.81890. eCollection 2025 Apr.

Possible Capecitabine-Induced Coronary Vasospasm and Myocardial Infarction

Deepa Soodi  1 , Vinod Kumar Reddy Cirra  2 , Guruprasad D Naik  3   1 , Param Sharma  1
Affiliations
Case Reports

Possible Capecitabine-Induced Coronary Vasospasm and Myocardial Infarction

Deepa Soodi et al. Cureus. .

Abstract

Capecitabine is a 5-fluorouracil precursor, approved for breast and colorectal cancer. We report a case of capecitabine-induced coronary vasospasm. A 77-year-old woman with breast cancer receiving capecitabine presented with chest pain, and an electrocardiogram demonstrated acute anterior-lateral myocardial infarction. Coronary angiography demonstrated normal coronary arteries. Discontinuation of capecitabine resolved symptoms. Failing to identify the cardiotoxicity associated with capecitabine could have had serious consequences.

Keywords: capecitabine side effects; chemotherapy-related toxicity; coronary artery vasospasm; myocardial infarction; st-segment elevation myocardial infarction (stemi).

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. ECG showing ST elevation in multiple leads (red arrows)
ECG: electrocardiogram; aVR: augmented vector right; aVL: augmented unipolar lead; aVF: augmented vector foot
Figure 2
Figure 2. ECG with resolution of ST elevation
ECG: electrocardiogram; aVR: augmented vector right; aVL: augmented unipolar lead; aVF: augmented vector foot
Figure 3
Figure 3. Coronary angiogram showing normal left coronary arteries
Figure 4
Figure 4. Coronary angiogram showing normal right coronary artery
Figure 5
Figure 5. ECG with ST elevations in multiple leads (red arrows)
ECG: electrocardiogram; aVR: augmented vector right; aVL: augmented unipolar lead; aVF: augmented vector foot
See this image and copyright information in PMC

References

    1. 5-Fluorouracil induces arterial vasocontractions. Südhoff T, Enderle MD, Pahlke M, Petz C, Teschendorf C, Graeven U, Schmiegel W. Ann Oncol. 2004;15:661–664. - PubMed
    1. Fluoropyrimidine-associated cardiotoxicity. Kanduri J, More LA, Godishala A, Asnani A. Cardiol Clin. 2019;37:399–405. - PubMed
    1. Failure of preventing 5-fluorouracil cardiotoxicity by prophylactic treatment with verapamil. Eskilsson J, Albertsson M. Acta Oncol. 1990;29:1001–1003. - PubMed
    1. Capecitabine-induced coronary vasospasm. Goldsmith YB, Roistacher N, Baum MS. J Clin Oncol. 2008;26:3802–3804. - PubMed
    1. Acute chest pain in a patient treated with capecitabine. Camaro C, Danse PW, Bosker HA. Neth Heart J. 2009;17:288–291. - PMC - PubMed

Publication types

LinkOut - more resources