Reversible Heart Dysfunction After FLOT Chemotherapy for Gastric Cancer
This gastric cancer diagnosis at a glance
- Stage at diagnosis
- Stage IV
- Sex
- Female
- Treatment
- chemotherapy
- Outcome
- Care Ongoing
Treatment course, step by step
- She began FLOT chemotherapy with a 48-hour 5-fluorouracil infusion.
- After acute speech changes and reversible heart dysfunction, FLOT was stopped and she received supportive cardiac treatment.
- Her later chemotherapy was changed to carboplatin and paclitaxel.
What happened, in summary
A 54-year-old woman with stage IV gastric cancer developed sudden difficulty speaking 1 day after starting FLOT chemotherapy. The regimen included 5-fluorouracil, leucovorin, oxaliplatin, and docetaxel, with 5-fluorouracil given over 48 hours. She had no limb weakness, chest pain, shortness of breath, headache, vision changes, or palpitations. Her speech improved spontaneously within hours.
During the admission, she had chemotherapy-related vomiting and a temporary drop in blood pressure to 80/50 mm Hg with a heart rate of 120 beats per minute. Testing also found severe new weakness of the heart muscle without blocked coronary arteries. The timing and rapid reversibility supported 5-fluorouracil-related cardiotoxicity.
She was managed conservatively and started carvedilol and lisinopril, then discharged with a wearable defibrillator. At follow-up 1 week later, her ejection fraction had fully recovered to 65%. Because of the suspected 5-fluorouracil reaction, her subsequent gastric-cancer chemotherapy was changed to carboplatin and paclitaxel.
Where this story comes from
This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full
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Collections this story belongs to
- Stage 4 Gastric Cancer 72 stories
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