Tex Heart Inst J 41(1): 80-82

Rituximab-Vincristine Chemotherapy-Induced Acute Anterior Wall Myocardial Infarction with Cardiogenic Shock

Department of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi 110029, India

^{Corresponding author.}

Address for reprints: Ambuj Roy, MD, DM, Department of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi 110029, India

E-mail:Email: moc.liamtoh@yorjubmard

Department of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi 110029, India

Address for reprints: Ambuj Roy, MD, DM, Department of Cardiology, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi 110029, IndiaE-mail:Email: moc.liamtoh@yorjubmard

Abstract

We present a case of an elderly man with coronary artery disease who was diagnosed with non-Hodgkin lymphoma. Soon after the administration of chemotherapy, which included rituximab and vincristine, he developed acute myocardial infarction with cardiogenic shock. The condition was managed successfully with primary percutaneous coronary intervention. We briefly discuss the possible pathogenic mechanisms of chemotherapy-induced ischemic syndrome and the management of chemotherapy in patients with high cardiovascular risk.

Key words: Acute coronary syndrome/chemically induced, acute myocardial infarction/chemically induced, antineoplastic agents/toxicity, cardiotoxins, endothelium, vascular/drug effects, lymphoma, non-Hodgkin, percutaneous coronary intervention, rituximab/adverse effects, tubulin/metabolism, vincristine/adverse effects

Abstract

Chemotherapy-induced cardiovascular complications include myocardial dysfunction, conduction abnormalities (arrhythmias), hypertension, venous thrombosis, and ischemic syndromes.¹ Chemotherapy-induced left ventricular (LV) dysfunction is often encountered in clinical practice, but chemotherapy-mediated ischemic syndromes are rarely seen. The incidence of acute myocardial infarction (AMI) after chemotherapy varies from 1% to 5%.¹ We describe the case of an elderly man with non-Hodgkin lymphoma (NHL) who developed AMI after the administration of chemotherapeutic agents.

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