Case report: Acute toxic myocardial damage caused by 5-fluorouracil—from enigma to success

Lasica, Ratko; Spasić, Jelena; Djukanovic, Lazar; Trifunović, Danijela; Orlić, Dejan; Nedeljkovic‐Arsenovic, Olga; Ašanin, Milika

doi:10.3389/fcvm.2022.991886

Cited by 6 publications

(2 citation statements)

References 62 publications

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“…Cardiomagnetic resonance is the non-invasive gold standard in hemodynamically stable patients with myocarditis. CMR is recommended in patients with clinically suspected AM or in patients with chest pain, normal coronary arteries, and raised troponin, for differential diagnosis of ischemic versus nonischemic origin (2,96). Sensitivity and specificity of CMR for diagnosing myocarditis is high (87.5% and 96.2%) (16,97).…”

Section: Cardiomagnetic Resonancementioning

confidence: 99%

Giant cell myocarditis in modern clinical practice

Lasica,

Đukanović,

Zdravković

et al. 2023

Medicinska istraživanja

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Giant cell myocarditis is a rare but extremely severe disease with a frequent need for heart transplantation and a high mortality rate. To this day, the most common reason for the occurrence of this disease has not been precisely determined, but its frequent association with autoimmune diseases speaks in favor of autoimmune etiology. Clinically, it is presented to the greatest extent by symptoms and signs of acute heart failure and ventricular rhythm disturbances, which are registered in as many as half of the patients. Arrhythmias can be accompanied by the occurrence of palpitations, repeated syncope, and even sudden cardiac death. A severe degree of acute heart failure in hemodynamically unstable patents who respond inadequately to the administered therapy for heart failure and refractory heart rhythm disorders and/or conduction disorders that are common in these patients should always raise suspicion of giant cell myocarditis. Given that changes in electrocardiogram, echocardiography and positive biomarker values are not strictly specific for this disease, the diagnosis of giant cell myocarditis is most often established by endomyocardial biopsy, especially in patients with the fulminant form of the disease. Timely endomyocardial biopsy enables not only quick and accurate diagnosis, but also early administration of immunosuppressive therapy, which greatly improves the outcome in these patients. Pathohistological verification of this disease is important so as to rule out cardiac sarcoidosis and other granulomatous infectious and non-infectious diseases. Given that in a large number of patients the disease has a fulminant course, early and rapid diagnosis, application of inotropic stimulation and mechanical circulatory support in hemodynamically unstable patients and adequate modern therapeutic regimen can largely reduce mortality in these patients, which is still high despite modern diagnostics and therapeutic progress of medicine.

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Section: Cardiomagnetic Resonancementioning

confidence: 99%

Giant cell myocarditis in modern clinical practice

Lasica,

Đukanović,

Zdravković

et al. 2023

Medicinska istraživanja

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“…Patients with acute myocarditis and acute pericarditis may complain of similar symptoms. It is sometimes difficult to make a differential diagnosis between acute myocarditis and non-ischemic cardiomyopathy (Takotcubo cardiomyopathy) or drug-induced cardiomyopathy [203,204] (Figure 2). disappear within 24 h (49%) or 48 h (74%) [129].…”

Section: Differential Diagnosismentioning

confidence: 99%

Update on Myocarditis: From Etiology and Clinical Picture to Modern Diagnostics and Methods of Treatment

Lasica,

Djukanovic,

Savic

et al. 2023

Diagnostics

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Although the frequency of myocarditis in the general population is very difficult to accurately determine due to the large number of asymptomatic cases, the incidence of this disease is increasing significantly due to better defined criteria for diagnosis and the development of modern diagnostic methods. The multitude of different etiological factors, the diversity of the clinical picture, and the variability of the diagnostic findings make this disease often demanding both for the selection of the diagnostic modality and for the proper therapeutic approach. The previously known most common viral etiology of this disease is today overshadowed by new findings based on immune-mediated processes, associated with diseases that in their natural course can lead to myocardial involvement, as well as the iatrogenic cause of myocarditis, which is due to use of immune checkpoint inhibitors in the treatment of cancer patients. Suspecting that a patient with polymorphic and non-specific clinical signs and symptoms, such as changes in ECG and echocardiography readings, has myocarditis is the starting point in the diagnostic algorithm. Cardio magnetic resonance imaging is non-invasive and is the gold standard for diagnosis and clinical follow-up of these patients. Endomyocardial biopsy as an invasive method is the diagnostic choice in life-threatening cases with suspicion of fulminant myocarditis where the diagnosis has not yet established or there is no adequate response to the applied therapeutic regimen. The treatment of myocarditis is increasingly demanding and includes conservative methods of treating heart failure, immunomodulatory and immunospressive therapy, methods of mechanical circulatory support, and heart transplantation. The goal of developing new diagnostic and therapeutic methods is to reduce mortality from this complex disease, which is still high.

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Studies on polyethylene glycol crosslinked chitosan nanoparticles for co-delivery of docetaxel and 5-fluorouracil with synergistic effect against cancer

Manivannan,

Narayan

2024

Macromol. Res.

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Case report: Acute toxic myocardial damage caused by 5-fluorouracil—from enigma to success

Cited by 6 publications

References 62 publications

Giant cell myocarditis in modern clinical practice

Giant cell myocarditis in modern clinical practice

Update on Myocarditis: From Etiology and Clinical Picture to Modern Diagnostics and Methods of Treatment

Studies on polyethylene glycol crosslinked chitosan nanoparticles for co-delivery of docetaxel and 5-fluorouracil with synergistic effect against cancer

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