3.
Four-chamberview of
a
weeklater with
Figure
echocardiograrn
function was nownear-normal.
disappearance
ventricular
ofthe thrombus. Left
Ischemic
have been
of chest
and
nausea,
coronary complications
pain,
electrocardiographic
weakness
with
with with acute endothelial
but rather
fol-
reported
cisplatin,
changes
generalized
and
as
lowed
autoim-
possible
acute thromboembolism. He had no
by
injury, vasospasm, hypomagnesemia,
mune
known cardiac illness and his left ventricular
responses being postulated
5-FU and
an added risk for
function
medication. This
mechanisms.ll-14 Combined
seems to
on
his
cisplatin
dramatically improved
stopping
to an
toxic
acute and
pose
chemotherapy
points
5-FU is believed to be
lethal
cardiotoxicity,15,16 though
potentially
cardiomyopathy.
to
the
contributor
and
to be added risk factors for
Concomitant
treated severe left ventricular
Successfully
major
toxicity.
disease
with intracardiac thrombi and aortic
coronary
dysfunction
radiotherapy
preexisting
embolization is rather uncommon. In an exten-
appear
Pottage
may
cardiotoxicity.
et al17
sensitize the
that radiation to the chest
for 5-FU car-
sive review of 5-FU
Robben et
reported
cardiotoxicity by
the
a
incidence of
a
thromboembolicevent
al,2
myocardium
only
Ourpatient had
localized
was
case.
et al19
also
radia-
Martin
diotoxicity.
only
single post-mortem
tion to the
with
have described
similar
carcinoma of
moid the soft
a
with
palate,
presumably negligible
necropsy study
startlingly
effect on the heart.
in
a
with
circumstances,
patient
palate
epider-
left
Severe
ventricular
with increased
is
a
serious
treated with
dysfunction
incidence of
treatment-related deaths.
and 5-FU. Most
that left ventricular function
have
complication,
cisplatin
reported
investigators
and more
arrhythmias
usually
et al18 described
ventricular
a
6%
incidence of
Jakubowski
returns to near-normal after discontinuation of
left
severe
with
combined
This
a
window of
dysfunction
therapy.
for successful outcome.
tion is with dilated
presents
opportunity
and
infusion
5-FU
The risk of
continuous
a
emboliza-
cisplatin therapy. High-dose
of
and
a
com-
a
5-FU,
for
cisplatin,
therapy
highest
cardiomyopathy.2o~21
used
of the head and
carcinomas
as
not,
monly
regimen
epidermoid
however,
pre-
development
may
Timely anticoagulation
been
has
vent
embolization.22,23 The
neck,
implicated
systemic
more cardiotoxic.8-10
did not
is
be sec-
to
our
of
thrombi
intracardiac
being
patient
Suprisingly,
presumed
with
the
markedleft ventricular
to the
typical
present
symptoms
ondary
dysfunction.
876
Hill
