Spontaneous coronary artery dissection during cisplatin and capecitabine therapy

Abstract

Introduction Spontaneous coronary artery dissection is a rare cardiovascular disease that can cause acute myocardial infarction and sudden cardiac death. The mechanism of this pathology and the optimal treatment are not fully understood. Presentation of case An acute myocardial infarction developed while a fifty five years old woman with a rectal adenocarcinoma was receiving a cisplatin and capecitabine therapy. Coronary angiography demonstrated a multivessel occlusion of coronary arteries. Discussion The authors discuss several factors that may lead to the spontaneous coronary artery dissection including chemotherapy-induced vasospasm. Chemotherapy based on the cisplatin and capecitabine intake can cause a cardiotoxic effect. Conclusion Thus, spontaneous coronary artery dissection is a disease with an extremely complex etiololy, which does not have a special treatment guide. Management should be considered individually for each case.

Peripheral Blood Gene Expression Profiling Reveals Molecular Pathways Associated with Cervical Artery Dissection

“…The connection between ribosome biogenesis and tumor transformation was supported by accelerated ribosome biogenesis in actively dividing tumor cells [46]. Spontaneous dissection of the coronary [47][48][49][50] and cervical arteries [51][52][53] has been described as a side effect of chemotherapy, which inhibits rRNA transcription (dactinomycin, doxorubicin, oxaliplatin, etc.) or VEGF signaling (bevacizumab, ranibizumab, sorafenib, etc.)…”

Recurrent Spontaneous Coronary Artery Dissection: A Case of Triple Trouble

“…It is interesting to consider that our patient received chemotherapy for breast cancer and case reports of SCAD occurring acutely following chemotherapy have been published. 10 , 11 Chemotherapeutic agents of multiple classes are known to induce oxidative stress and cause direct endothelial damage resulting in an increased risk of heart failure and CAD (Coronary artery disease) in the long term. 12 Chemotherapy-related ACS mechanisms include diffuse coronary vasospasm due to hyperreactivity, accelerated fibrous intimal proliferation and prothrombotic states, leading to plaque formation.…”

Myocardial Ischemia Related to Common Cancer Therapy—Prevention Insights

“…Spontaneous coronary artery dissection during cisplatin therapy is extremely rare [ 57 ]. In a 33-year-old man who presented STEMI at the end of the first cycle of CT, coronary angiography revealed a circumscribed stenosis of the circumflex artery with intima dissection and associated thrombosis and no atherosclerotic plaque [ 58 ].…”