A Case of Coronary Vasospasm after Repeat Rituximab Infusion

Coronary artery vasospasm (CAV) can be triggered by medication reactions. CAV occurring after multiple exposures to rituximab has not been previously described. A 61-year-old woman with no cardiac risk factors was treated with the sixth cycle of gemcitabine, cisplatin, dexamethasone, and rituximab therapy. Fifteen minutes after rituximab infusion commenced, she developed typical cardiac chest pain with ST segment elevations on electrocardiogram. Angiogram revealed evidence of coronary vasospasm. The patient was successfully treated with amlodipine. This case underlines the importance of monitoring cardiac side effects of rituximab therapy, even after multiple cycles.

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A Lethal Side Effect of Treatment by Macitentan

10.37191/mapsci-jccr-1(1)-007 ◽

2020 ◽

Author(s):

Oumaima Naour

Keyword(s):

Chest Pain ◽

Side Effects ◽

Side Effect ◽

Acute Myocarditis ◽

Human Case ◽

Double Outlet Right Ventricle ◽

St Segment Elevation ◽

Cardiac Side Effects ◽

St Segment ◽

Pulmonary Arterial

Pulmonary arterial hypertension is a progressive and ultimately fatal disease despite the availability of a number of new therapies, including endothelin receptor antagonists. Many side effects have been reported with the use of these drugs, such as hepatotoxicity, peripheral edema, anemia and other digestive reactions. Cardiac side effects have been rarely mentioned. We report the case of a 17-year-old girl with Eisenmenger syndrome secondary to double outlet right ventricle and sub-pulmonary ventricular septal defect, Macitentan treatment has been started, three days later, she presented a ST segment elevation in septo-apico- lateral territory which shortly complicated with cardiogenic shock and death. A coronary arteritis or acute myocarditis of toxic origin was the two evoked diagnoses. This is the first human case in the medical literature describing a relationship between initiation of Macitentan and the onset of this event. This case highlights a lethal side effect of Macitentan, which should prompt patients to notify their doctors of any symptoms suggestive of coronary or myocardial injury (chest pain, dyspnea, heart failure symptoms), and implementation of electrocardiogram in combination with a control in any patient who develops chest pain on Macitentan.

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What the Cardiologist Needs to Consider in the Management of Oncologic Patients with STEMI-Like Syndrome; A Case Report and Literature Review

Pharmaceuticals ◽

10.3390/ph14060563 ◽

2021 ◽

Vol 14 (6) ◽

pp. 563

Author(s):

Aneta Aleksova ◽

Giulia Gagno ◽

Alessandro Pierri ◽

Carla Todaro ◽

Alessandra Lucia Fluca ◽

...

Keyword(s):

Myocardial Infarction ◽

Case Report ◽

Side Effects ◽

Single Agent ◽

St Segment Elevation ◽

Cardiac Catheterization Laboratory ◽

Cardiac Side Effects ◽

Coronary Syndrome ◽

St Segment ◽

Oncologic Patients

In pre-hospital care, an accurate and quick diagnosis of ST-segment elevation myocardial infarction (STEMI) is imperative to promptly kick-off the STEMI network with a direct transfer to the cardiac catheterization laboratory (cath lab) in order to reduce myocardial infarction size and mortality. Aa atherosclerotic plaque rupture is the main mechanism responsible for STEMI. However, in a small percentage of patients, emergency coronarography does not reveal any significant coronary stenosis. The fluoropyrimidine agents such as 5-Fluorouracil (5-FU) and capecitabine, widely used to treat gastrointestinal, breast, head and neck cancers, either as a single agent or in combination with other chemotherapies, can cause potentially lethal cardiac side effects. Here, we present the case of a patient with 5-FU cardiotoxicity resulting in an acute coronary syndrome (ACS) with recurrent episodes of chest pain and ST-segment elevation.. Our case report highlights the importance of widening the knowledge among cardiologists of the side effects of chemotherapeutic drugs, especially considering the rising number of cancer patients around the world and that fluoropyrimidines are the main treatment for many types of cancer, both in adjuvant and advanced settings.

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Spontaneous coronary artery dissection in association with cabergoline therapy

BMJ Case Reports ◽

10.1136/bcr-2020-240022 ◽

2021 ◽

Vol 14 (2) ◽

pp. e240022

Author(s):

Zia Saleh ◽

Susan Koshy ◽

Vaninder Sidhu ◽

Andrea Opgenorth ◽

Janek Senaratne

Keyword(s):

Risk Factors ◽

Acute Coronary Syndrome ◽

Coronary Artery ◽

Cardiac Risk ◽

Artery Dissection ◽

Spontaneous Coronary Artery Dissection ◽

Coronary Artery Dissection ◽

Coronary Syndrome ◽

Ergot Derivative

Spontaneous coronary artery dissection (SCAD) is a rare but increasingly recognised cause of acute coronary syndrome. While numerous risk factors are associated with SCAD, one potential cause is coronary artery vasospasm. The use of cabergoline—an ergot derivative and dopamine agonist that may induce vasospasm—has been associated with SCAD in one other case report worldwide. Here, we describe SCAD in a 37-year-old woman on long-term cabergoline therapy with no other cardiac risk factors. Cabergoline-induced SCAD should be considered in patients presenting with an acute coronary syndrome who are treated with this medication.

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