Possible Capecitabine-Induced Coronary Vasospasm and Myocardial Infarction

Capecitabine is a 5-fluorouracil precursor, approved for breast and colorectal cancer. We report a case of capecitabine-induced coronary vasospasm. A 77-year-old woman with breast cancer receiving capecitabine presented with chest pain, and an electrocardiogram demonstrated acute anterior-lateral myocardial infarction. Coronary angiography demonstrated normal coronary arteries. Discontinuation of capecitabine resolved symptoms. Failing to identify the cardiotoxicity associated with capecitabine could have had serious consequences.