Gemcitabine
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Myocardial infarction: case report A 43-year-old woman developed acute myocardial infarction during treatment with gemcitabine for metastatic lung cancer. The woman, who had a history of a stroke, postpartum cardiomyopathy, a myocardial infarction 3 years earlier and coronary stent implantation, started treatment with gemcitabine 1000 mg/m2 and docetaxel on a 2 weeks on, 1 week off cycle. After two cycles (4 infusions), she received monotherapy with gemcitabine 1000 mg/m2. Three days after her first dose of gemcitabine monotherapy, she developed nausea and vomiting and presented with intermittent midsternal chest pain. On admission, she became unresponsive and underwent cardiopulmonary resuscitation for ventricular tachycardia. Sinus rhythm was restored after cardioversion and intubation. Examination revealed tachycardia of 100–120 beats/min and hypertension of 150/140mm Hg, and laboratory investigations revealed elevated serum cardiac markers. An ECG during the episode of chest pain, prior to heart arrest, revealed frequent complex ventricular ectopic beats, polymorphic ventricular tachycardia and acute ST elevation and ST depression. A subsequent ECG revealed T-wave inversion, ST segment depression and a prolonged QTc interval. Echocardiography showed inferior wall hypokinesis with an ejection fraction of 35%. The woman received aspirin, heparin, glycoproteins, nitrates and β-adrenoceptor antagonists. She was extubated after 2 days and discharged 2 days later. Gemcitabine was discontinued and she subsequently received gefitinib. Bdair FM, et al. Gemcitabine and acute myocardial infarction - a case report. 801040632 Angiology 57: 367-371, No. 3, May-Jun 2006 - USA
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Reactions 22 Jul 2006 No. 1111
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