Ischemic Heart Disease Associated with Vincristine and Doxorubicin Chemotherapy

Abstract

OBJECTIVE:

To report the ocurrence of ischemic heart disease (IHD) in a patient with multiple myeloma treated with vincristine and doxorubicin.

CASE SUMMARY:

A 46-year-old man developed a Q-wave inferior and right-ventricle myocardial infarction with postinfarction angina after receiving his third cycle of vincristine and doxorubicin for immunoglobulin A multiple myeloma. Angiography showed two small filling defects consistent with thrombi in the distal right coronary artery.

DISCUSSION:

IHD may be a serious but uncommon complication of treatment with several chemotherapeutic agents. It is likely that chemotherapy played a role in the development of IHD in our patient. Several putative mechanisms for vascular toxicity have been associated with chemotherapy.

CONCLUSIONS:

Chemotherapy with vincristine and doxorubicin may play a role in the ocurrence of IHD. Physicians should possess an awareness of this potentially serious complication of chemotherapy.