Cardiotoxic effects of antitumor chemotherapy in the treatment of a patient with gastric adenocarcinoma

Background. Fluoropyrimidines such as 5-fluorouracil and its oral prodrug capecitabine are widely used in treating gastrointestinal malignancies but are associated with potentially severe cardiotoxicity. Nephrotoxicity associated with platinum-based therapies (Cisplatin, Oxaliplatin). Case summary. We present the case of a 60-year-old man with resected gastric adenocarcinoma (T3N 2M0) treated with adjuvant FOLFOX (5-fluorouracil plus oxaliplatin). On the first day of the second cycle, he developed tachycardia. Electrocardiogram showed supraventricular tachycardia and on next day-atrial flutter, while echocardiography demonstrated reduced ejection fraction. Troponin I was 2.7. Chemotherapy was discontinued, and a reduced dose of capecitabine was recommended. Conclusions. This case illustrates the cardiotoxicity of oxaliplatin, with both supraventricular tachycardia and atrial flutter, while echocardiography demonstrated reduced ejection fraction.