Rare Presentation of Cardiotoxicity Related to 5-Fluorouracil

5-Fluorouracil (5-FU) is a chemotherapeutic agent frequently used for the treatment of solid tumors. In a few cases, 5-FU can beassociated with coronary vasospasm, cardiac ischemia, or life-threatening arrhythmias. Recognition of 5-FU cardiotoxicity isclinically important as after the rapid sensation of therapy, cardiotoxicity can be completely reversible, and on the other hand,readministration may lead to serious damage of the heart and even death. A 70-year-old male came to the emergencydepartment (ED) with chest pain which started while receiving an infusion of 5-FU. The patient did not have a personal historyor risk factors of coronary artery disease and his electrocardiogram (ECG) before starting chemotherapy was completely normal.In the ED, his ECG had ischemic changes, troponin was elevated, and echocardiogram showed anterior wall hypokinesis.However, emergent coronary angiogram did not reveal any acute coronary occlusion. 5-FU-induced cardiotoxicity wassuspected; the patient was admitted to a progressive care unit for close monitoring and infusion of calcium channel blockers wasinitiated. The patient’s symptoms and ECGfindings gradually resolved, and two days later on discharge, patient was chest painfree and ECG was normal. This case supports the vasospastic hypothesis of 5-FU cardiac toxicity, describes its clinical course,and emphasizes the importance of better awareness and early recognition of the rare side effect as it may allow physicians toreduce the risk of life-threatening complications