ArticleRadiology case reports2026
Unmasking 5-fluorouracil cardiotoxicity: The clinical utility of dynamic myocardial CT perfusion: A case report.
Article in Radiology case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
We report the first documented case in Peru of 5-fluorouracil (5-FU)-induced cardiotoxicity assessed using combined coronary computed tomography angiography (CCTA) and dynamic myocardial computed tomography perfusion (CTP). A 57-year-old male with metastatic pancreatic cancer undergoing FOLFOX chemotherapy developed chest pain during the second cycle. Coronary computed tomography angiography (CCTA) revealed non-obstructive calcified plaques, ruling out significant coronary artery disease. Due to a history of active asthma, adenosine stress was contraindicated; therefore, a hyperventilation-apnea maneuver was employed as an alternative pharmacologic stress method. Dynamic CTP imaging demonstrated global myocardial hypoperfusion under stress conditions without infarction, consistent with coronary vasospasm induced by 5-FU. This case highlights the diagnostic value of combining anatomical and functional CT imaging modalities for noninvasive evaluation of cardiotoxicity in oncology patients. Additionally, the hyperventilation-apnea maneuver proved to be a feasible and safe stress alternative in patients contraindicated for pharmacologic agents. Further studies are warranted to establish the role of dynamic CTP in the early detection and management of fluoropyrimidine-induced cardiotoxicity.
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