CASE REPORT Acute coronary syndrome associated with NIGRO protocol in anal cancer

Abstract

5-fluorouracil (5-FU) cardiotoxicity is not a common, but with potentially deleterious effects on the patient condition. In this paper we present the case of an 53-year-old woman undergone local resection for localized anal cancer and then she was treated with NIGRO protocol. 48 hours after the end of 5-FU i.v. administration an acute coronary syndrome was developed. The electrocardiogram showed hyperacute T waves in all leads except for V1 and aVL that showed negative T waves in combination with chest pain and diaphoresis promptly resolved after sublingual isosorbide dinitrate. A subsequent coronary angiography was performed and normal coronary arteries were shown. The potential causes and the treatment are being discussing.

Keywords

• acute coronary syndrome
• 5-fu cardiotoxicity
• anal cancer
• nigro protocol