Acute ischaemic stroke and myocardial infarction after chemotherapy with vinorelbine for non-small cell lung cancer: a case report

J Chemother. 2017 Feb;29(1):49-53. doi: 10.1179/1973947814Y.0000000232. Epub 2016 Jul 22.

Abstract

Vinorelbine is an important chemotherapeutic agent which is used in metastatic non-small cell lung cancer. Case reports have described the occurrence of acute cardiac ischaemic events as a side effect. It has not been established whether the suspected mechanisms for cardiac ischaemia might also cause other vascular events. We report about a 70-year-old male with metastatic non-small cell lung cancer who received vinorelbine as an outpatient. The patient presents with a cardiovascular risk profile. He was admitted to the hospital 3 days later with acute left-sided hemiplegia and hemianopia. Brain computed tomography (CT) demonstrated acute right hemispheric ischaemic stroke. Nine days after admission, the patient additionally suffered ST elevation myocardial infarction. A coronary angiogram demonstrated high grade stenosis of the right coronary artery treated with two bare-metal stents. Caution should be noted in patients who present with a cardiovascular risk profile as they might be vulnerable experiencing acute ischaemic events.

Keywords: Cardiovascular risk profile; Metastatic non-small cell lung cancer; Myocardial infarction; Stroke; Vinorelbine.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents, Phytogenic / adverse effects*
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / epidemiology
  • Comorbidity
  • Humans
  • Hypercholesterolemia / epidemiology
  • Hypertension / epidemiology
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / epidemiology
  • Male
  • Myocardial Infarction / chemically induced*
  • Peripheral Arterial Disease / epidemiology
  • Risk Factors
  • Smoking
  • Stroke / chemically induced*
  • Vinblastine / adverse effects
  • Vinblastine / analogs & derivatives*
  • Vinorelbine

Substances

  • Antineoplastic Agents, Phytogenic
  • Vinblastine
  • Vinorelbine