Paclitaxel
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Paclitaxel Hypersensitivity reactions manifesting as chest pain, dizziness and left bundle branch block: case report
A 60-year-old woman developed hypersensitivity reactions manifesting as chest pain, dizziness and left bundle branch block (LBBB) during treatment with paclitaxel for endometrial clear-cell adenocarcinoma. The woman, who had endometrial clear-cell adenocarcinoma, was admitted to receive the chemotherapy. She subsequently started receiving IV infusion of paclitaxel at a standard rate of 135 mg/m2 over 3 hours. However, 30 minutes into the infusion, she complained of heavy chest pain (chest discomfort) and dizziness. Her medical history was significant for hypertension, type II diabetes and hyperlipidaemia. At this point, her BP was 105/59mm Hg, pulse was 75 beats/minute and the oxygen saturation was 95% (ambient air). Cardiopulmonary physical examination revealed reverse splitting of the second heart sound. The ECG findings revealed LBBB. Based on the clinical presentation and based on the lab tests, hypersensitivity reactions manifesting as chest pain, dizziness and left bundle branch block were suspected. The woman’s paclitaxel infusion was therefore stopped, and within 10 minutes, her symptoms spontaneously resolved. Other laboratory examinations (complete blood count, comprehensive metabolic panel and ventricular function) were found to be normal. Serial troponin I levels at 3–6 hours of her admission was negative. She was also found to be free from obstructive coronary disease. Consequently, she was switched to an alternative chemotherapy regimen for endometrial clear-cell adenocarcinoma. At 1-week follow-up, she remained symptom free, and a repeat ECG revealed resolution of LBBB. Brenes-Salazar JA. Paclitaxel-induced chest pain and left bundle branch block in the absence of cardiac ischemia. Indian Journal of Critical Care Medicine 23: 526-528, No. 803498402 11, Nov 2019. Available from: URL: http://doi.org/10.5005/jp-journals-10071-23281
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Reactions 29 Aug 2020 No. 1819
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