High incidence of Angina pectoris in patients treated with 5-fluorouracil - A planned surveillance study with 102 patients

Objective: Angina pectoris, arrhythmic sudden death and myocardial
infarction, all these cardiac events have occasionally been
reported during 5-fluorouracil (5-FU) chemotherapy. Underlying
mechanisms leading to these events are unknown; damage to the
myocytes or vasospasms have been discussed. Methods: 102
consecutive and unselected patients were monitored with 12-lead
ECG, echocardiography and radionuclide ventriculography prior to
the first cycle of 5-FU chemotherapy and 3 months from baseline.
Results: 19% of the patients developed reversible symptoms of
angina pectoris during treatment which lasted up to 12 h after
cessation of the infusion. Most of the 19 patients showed
corresponding ECG changes. 6 out of the 19 patients with severe
angina pectoris had subsequent coronary angiography. In none of
these patients the coronary angiography showed coronary artery
disease, but it showed low ventricular function (ejection fraction