JACC. Case reports · 2026
FOLFOX-Associated Ventricular Fibrillation Arrest in a Patient With Colon Cancer.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Al Osta Soad, Ahmed Marwan, Xu Weining David, Jalaly Niloo
Аннотация
BACKGROUND: Fluoropyrimidine cardiotoxicity is uncommon but may cause life-threatening ventricular arrhythmias.
CASE SUMMARY: A 43-year-old man with stage IIIB colon cancer developed chest discomfort and out-of-hospital ventricular fibrillation arrest approximately 72 hours after his first folinic acid (leucovorin), fluorouracil (5-FU), and oxaliplatin (FOLFOX) cycle. Electrocardiography showed anterior ST-segment elevations, but coronary angiography demonstrated nonobstructive left and right coronary arteries. Echocardiography showed a left ventricular ejection fraction of 25% to 30%, which improved to approximately 50% on cardiac magnetic resonance imaging without myocardial edema or late gadolinium enhancement. FOLFOX was discontinued, guideline-directed medical therapy was initiated, and an extravascular implantable cardioverter-defibrillator was placed for secondary prevention.
DISCUSSION: This case highlights a rare, severe presentation of fluoropyrimidine cardiotoxicity after the first treatment cycle despite no prior cardiac history.
TAKE-HOME MESSAGE: Ventricular fibrillation may occur early during FOLFOX therapy. Prompt recognition and multidisciplinary cardio-oncology management are essential.
CASE SUMMARY: A 43-year-old man with stage IIIB colon cancer developed chest discomfort and out-of-hospital ventricular fibrillation arrest approximately 72 hours after his first folinic acid (leucovorin), fluorouracil (5-FU), and oxaliplatin (FOLFOX) cycle. Electrocardiography showed anterior ST-segment elevations, but coronary angiography demonstrated nonobstructive left and right coronary arteries. Echocardiography showed a left ventricular ejection fraction of 25% to 30%, which improved to approximately 50% on cardiac magnetic resonance imaging without myocardial edema or late gadolinium enhancement. FOLFOX was discontinued, guideline-directed medical therapy was initiated, and an extravascular implantable cardioverter-defibrillator was placed for secondary prevention.
DISCUSSION: This case highlights a rare, severe presentation of fluoropyrimidine cardiotoxicity after the first treatment cycle despite no prior cardiac history.
TAKE-HOME MESSAGE: Ventricular fibrillation may occur early during FOLFOX therapy. Prompt recognition and multidisciplinary cardio-oncology management are essential.