Paclitaxel-induced acute myocardial infarction: a case report and literature review

• Published in: BMC cardiovascular disorders 2024-03, Vol.24 (1), p.167-5, Article 167
• Main Authors: Kim, Gi Eun, Ibrahim, Ayman R, Shalatouni, Duha, Abouzeid, Nadin H, Othman, Fahmi
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Acute myocardial infarction; Aged; Apoptosis; Breast carcinoma; Cancer therapies; Cardiovascular disease; Care and treatment; Case Report; Case reports; Cell cycle; Chemotherapy; Complications and side effects; Constriction, Pathologic - etiology; Coronary artery disease; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - etiology; Coronary Artery Disease - therapy; Coronary vessels; Diabetes; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2; Diabetic neuropathy; Diagnosis; Dosage and administration; Drug dosages; Ejection fraction; Electrocardiography; Heart attack; Heart attacks; Heart diseases; Hemoglobin; Humans; Hypertension; Implants; Irritable bowel syndrome; Kaposi's sarcoma; Literature reviews; Lung cancer; Lung cancer, Non-small cell; Lung carcinoma; Male; Metastasis; Myelosuppression; Myocardial infarction; Myocardial Infarction - chemically induced; Myocardial Infarction - diagnostic imaging; Myocardial Infarction - therapy; Ovarian carcinoma; Oxygen saturation; Paclitaxel; Paclitaxel - adverse effects; Patient outcomes; Percutaneous Coronary Intervention - adverse effects; Peripheral neuropathy; Prevention; Pulmonary embolisms; Risk factors; Side effects; Stenosis; Stents; Thromboembolism; Transluminal angioplasty; Vein & artery diseases
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-024-03814-1

Paclitaxel is a chemotherapeutic agent commonly used for ovarian, lung, breast carcinoma, and Kaposi's sarcoma. Its common side effects include hypersensitivity reaction, bone marrow suppression, and peripheral neuropathy. However, a rare and life-threatening side effect is paclitaxel-induced myocardial infarction. A 71-year-old man with type 2 diabetes mellitus, hypertension, heavy smoking history, previous coronary artery disease with percutaneous coronary intervention (PCI) in left anterior descending artery (LAD), and non-small lung cancer presented with non-ST elevation myocardial infarction during infusion of paclitaxel infusion. Coronary angiogram showed de novo three vessel disease with 70% stenosis in ostial to distal left main artery (LM) and 80% in-stent re-stenosis in proximal to mid left anterior descending artery. Physicians should be keeping this in mind when dealing with patients on paclitaxel, especially if they have previous risk factors for coronary artery disease.