ArticleEuropean heart journal. Case reports2026
An oncologic cardiotoxicity masquerading as ST-elevated myocardial infarction: a case report.
Article in European heart journal. 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.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Fluoropyrimidines, such as 5-fluorouracil (5-FU), when used in combination with bevacizumab are associated with diverse cardiotoxic effects, including vasospasm, myocarditis, and myopericarditis. These toxicities may closely mimic acute coronary syndrome, creating diagnostic uncertainty and risk of inappropriate management. Cardiac magnetic resonance (CMR) is central in distinguishing inflammatory myocardial injury from ischaemic pathology. Case summary: A 71-year-old man undergoing long-term maintenance FOLFIRI-bevacizumab for metastatic colorectal cancer presented with acute chest pain and inferior ST-segment elevation 12 days after chemotherapy. Coronary angiography demonstrated non-obstructive coronary artery disease without a culprit lesion. Serial electrocardiographies showed dynamic evolution from ST elevation to widespread T-wave inversion, while peak high-sensitivity troponin reached 457 ng/L. Initial echocardiography revealed normal left ventricular ejection fraction. Cardiac magnetic resonance performed 1 week later demonstrated subepicardial late gadolinium enhancement and elevated regional T2 signal in the lateral segments, fulfilling the 2018 Lake Louise criteria for myopericarditis. Chemotherapy was withheld, and the patient was treated with colchicine, beta-blockade, and intermittent nitrates. Six-month follow-up imaging showed complete recovery of systolic function, permitting safe reintroduction of FOLFIRI-bevacizumab. Discussion: This case highlights a diagnostically challenging presentation of fluoropyrimidine-associated myopericarditis masquerading as ST-elevated myocardial infarction (STEMI). Synergistic endothelial injury from 5-FU and bevacizumab may lower the threshold for cardiotoxicity even after multiple well-tolerated cycles. Multimodality imaging, particularly CMR, was essential in confirming myocardial inflammation, excluding ischaemia, and guiding treatment decisions. Increased awareness of chemotherapy-related STEMI mimics is critical to prevent unnecessary interventions and allow safe continuation of oncologic therapy following cardiac recovery.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.