Cardiogenic Shock After 5-Fluorouracil Administration - A Case Report and Literature Review
Vanoverbeke Lowie, Holvoet Wouter, D’Heygere François, Elegeert Ivan- Cardiology and Cardiovascular Medicine
Abstract
Background
Cardiogenic shock is a rare adverse event of 5-fluorouracil (5-FU) administration. Because of its rare entity, little is known about epidemiologic and clinical features of 5-FU induced cardiogenic shock, and recommendations about specific treatment are missing.
Case summary
We present a case of cardiogenic shock and ventricular arrhythmia due to 5-FU induced toxic cardiomyopathy treated with vasopressor and inotropic drugs in combination with intra-aortic balloon pump. Because of persistent hemodynamic instability, veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and Impella were implanted as a bridge to recovery. Systolic function recovered completely and the patient was weaned successfully.
Discussion
This case demonstrates toxic cardiomyopathy as a rare and potentially lethal cardiac adverse event of 5-FU administration. This case emphasizes the importance of mechanical support as bridging therapy to recovery of cardiac function.