Acute Myocardial Infarction in Patient With Triple Negative Breast Cancer After Paclitaxel Infusion: A Case Report

Abstract

A 47-year-old woman with breast cancer suffered progressive chest pain and flushing within 5 minutes of her second exposure to paclitaxel. Her symptoms progressed and she became pulseless. Advanced cardiac life support (ACLS) was initiated, and after a series of chest compressions the cardiac monitor revealed ventricular fibrillation. With ongoing ACLS she was transferred to the emergency department where she regained a pulse. Review of electrocardiogram revealed prominent ST elevation in leads V1, V2 and V3 with reciprocal ST depression. She was transferred urgently to the catheterization laboratory. Angiography revealed a high-grade stenosis in the proximal left anterior descending artery (LAD), and drug-eluting stents were placed without complications. She was then transferred to the floor and shortly thereafter suffered pulseless electrical activity and died despite prolonged attempts at resuscitation. Herein, we describe the development of acute myocardial infarction after paclitaxel administration, discuss potential etiologies and review evidence for an allergic component.

Paclitaxel-induced acute myocardial infarction: A case report and literature review

“…Cardiovascular abnormalities are rare (< 1%) however includes bradycardia, atrial and ventricular arrhythmias, negative inotropic effect, and congestive heart failure 2 . A concerning cardiovascular side is life-threatening myocardial infarction, which has been reported in literature in 10 case reports [3][4][5][6][7][8][9][10][11][12] .…”

Acute ST-segment elevations following paclitaxel administration for uterine cervical cancer: a case report and literature review

“…1–4, 6–8) [ 8 – 11 , 13 – 15 ] and it even occurred in patients without cardiovascular risk factors (patient nos. 2, 4, 6 and 7) [ 9 , 11 , 13 , 14 ]. Although there is no universally accepted evidence regarding paclitaxel-induced vasospasm, vasodilator for example calcium blocker or nitroglycerin would be preferred when the patient is hemodynamically stable.…”

Type 1 Kounis syndrome after paclitaxel infusion in a patient treated for lung adenocarcinoma

“…Since 2009, a limited number of cases have reported its association with Type II and III KS. [1][2][3][4] We report a patient who presented with ACS shortly after paclitaxel infusion found to have no coronary artery disease on angiography. This is the first case report to our knowledge describing Type I KS with paclitaxel use.…”