Gemcitabine-Induced Acute Coronary Syndrome: A Case Report

Objectives: To report a case of metastatic leiomyosarcoma, in which a patient developed chest pain accompanied by acute left bundle-branch block (LBBB) after gemcitabine infusion. Clinical Presentation and Intervention: A 59-year-old woman admitted with bilateral pulmonary nodules had classic risk f...

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Bibliographic Details
Published in:Medical principles and practice 2009-01, Vol.18 (1), p.76-80
Main Authors: Ozturk, Banu, Tacoy, Gulten, Coskun, Ugur, Yaman, Emel, Sahin, Giray, Buyukberber, Suleyman, Yildiz, Ramazan, Kaya, Ali O., Topal, Salih, Ozdemir, Murat, Benekli, Mustafa
Format: Article
Language:English
Subjects:
Antimetabolites, Antineoplastic - adverse effects
Aspirin - therapeutic use
Bundle-Branch Block - chemically induced
Bundle-Branch Block - diagnosis
Bundle-Branch Block - drug therapy
Case Report
Coronary Artery Disease - complications
Coronary Vasospasm - chemically induced
Deoxycytidine - adverse effects
Deoxycytidine - analogs & derivatives
Electrocardiography
Fatal Outcome
Female
Humans
Leiomyosarcoma
Lung Neoplasms - secondary
Middle Aged
Platelet Aggregation Inhibitors - therapeutic use
Risk Factors
Ticlopidine - analogs & derivatives
Ticlopidine - therapeutic use
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Summary:Objectives: To report a case of metastatic leiomyosarcoma, in which a patient developed chest pain accompanied by acute left bundle-branch block (LBBB) after gemcitabine infusion. Clinical Presentation and Intervention: A 59-year-old woman admitted with bilateral pulmonary nodules had classic risk factors for coronary heart disease and coronary stenosis as demonstrated by previous coronary angiography. She was treated with gemcitabine infusion, and 30 min later she experienced severe chest pain accompanied by acute LBBB confirmed by ECG. We suspected gemcitabine-induced coronary vasospasm exacerbated by the preexisting coronary artery disease as the cause of the acute coronary syndrome. The patient was subsequently treated with antianginal therapy and percutaneous coronary intervention. Her chest pain resolved and LBBB disappeared. She was discharged 2 days later without any further cardiac events. No additional cancer therapy was given and she died 5 months later, due to disease progression. Conclusion: This case showed that chemotherapeutic agents must be administered with intensive cardiac monitoring especially in patients with cardiac disease and well-known risk factors to prevent the development of cardiac complications, despite an agent not being known to be ‘cardiotoxic’.
ISSN:1011-7571
1423-0151
DOI:10.1159/000163051