Work

Takotsubo Cardiomyopathy in a Patient Undergoing 5-Fluorouracil Infusion: Considerations for Folinic Acid, 5-Fluorouracil, and Oxaliplatin (FOLFOX) Cardiotoxicity and Rechallenge

Year: 2025

Type: article

Abstract: Takotsubo cardiomyopathy (TCM) is a rare but reversible cause of transient ventricular dysfunction, often triggered by sympathetic stimulation from physical or emotional stress. Patients with a history of TCM undergoing cardiotoxic chemotherapy such as FOLFOX (folinic acid, 5-fluorouracil (5-FU), and oxaliplatin) require vigilant monitoring due to potential cardiac complications, including coronary vasospasm and direct myocardial toxicity. We present a case of progressively worsening TCM diagnosed via coronary angiography and left ventriculography three days after a patient received their first FOLFOX infusion for sigmoid adenocarcinoma. The cardiomyopathy resolved with conservative management, and one month later, the patient was admitted for a monitored FOLFOX rechallenge in the telemetry unit, which she tolerated well. This case highlights the importance of cardiac surveillance in patients with prior TCM requiring chemotherapy and discusses strategies for minimizing cardiotoxic risk during 5-FU rechallenge.

Source: Cureus

DOI: 10.7759/cureus.82145

Authors: Nabeel Sami, Amit Raizada, Gabriella Jade Phillip, Dhara Rana, Shudhanshu Alishetti

Institutions: NewYork–Presbyterian Brooklyn Methodist Hospital, Inspira Medical Center Vineland

Language: English

Topic: Takotsubo Cardiomyopathy and Associated Phenomena

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4409387819