Spontaneous Coronary Artery Dissection in a Woman Receiving 5-Fluorouracil

Abstract

A 39-year-old woman with cervical cancer treated with pelvic radiation therapy and 5-fluo rouracil (5-FU) was hospitalized for dehydration and intractable vomiting. She developed an acute ST-elevation myocardial infarction (MI) that extended electrocardiographically after thrombolytic therapy. Coronary angiography demonstrated a completely occluded left anterior descending (LAD) artery with extensive coronary dissection that was treated successfully with stenting. The authors discuss several factors that may have contributed to the sponta neous coronary artery dissection (SCAD) including chemotherapy-induced vasospasm, hemo dynamic stress of vomiting, and hormonal changes associated with pelvic radiation.

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