2687-0940Challenges in modern medicine2687-094010.52575/2687-0940-2026-49-3-287-299299CARDIOLOGY<strong>Clinical Case of Myocardial Infarction against the Background of Chemotherapy</strong><strong>Clinical Case of Myocardial Infarction against the Background of Chemotherapy</strong>BolkhovitinaOlga A.BolkhovitinaOlga A.bolkhovitina_o@bsuedu.ruKrivulinaTatyana S.KrivulinaTatyana S.KonstantinovaYulia S.KonstantinovaYulia S.KuzminovaMaria N.KuzminovaMaria N.202649300

This article presents a clinical case of a 64-year-old male with pancreatic adenocarcinoma who developed a large anterior myocardial infarction (MI) during mFOLFIRINOX chemotherapy. The patient experienced angina leading to MI, complicated by a left ventricular aneurysm and apical thrombosis. Coronary angiography revealed ostial occlusion of the left anterior descending artery and multivessel disease. The MI resulted from a mixed mechanism: fluoropyrimidine-induced vasospasm exacerbated by chemotherapy-related anemia, hypovolemia, and underlying atherosclerosis. The patient underwent successful surgical revascularization and aneurysm repair. The authors emphasize that ischemic symptoms during fluoropyrimidine therapy require immediate cardiac evaluation. They advocate for pre-treatment cardiovascular risk stratification and close collaboration between oncologists and cardiologists to prevent severe cardiotoxic complications.

This article presents a clinical case of a 64-year-old male with pancreatic adenocarcinoma who developed a large anterior myocardial infarction (MI) during mFOLFIRINOX chemotherapy. The patient experienced angina leading to MI, complicated by a left ventricular aneurysm and apical thrombosis. Coronary angiography revealed ostial occlusion of the left anterior descending artery and multivessel disease. The MI resulted from a mixed mechanism: fluoropyrimidine-induced vasospasm exacerbated by chemotherapy-related anemia, hypovolemia, and underlying atherosclerosis. The patient underwent successful surgical revascularization and aneurysm repair. The authors emphasize that ischemic symptoms during fluoropyrimidine therapy require immediate cardiac evaluation. They advocate for pre-treatment cardiovascular risk stratification and close collaboration between oncologists and cardiologists to prevent severe cardiotoxic complications.

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