5-fluorouracil Induced Cardiotoxicity: Review of the Literature

Cardiol J. 2012;19(5):453-8. doi: 10.5603/cj.2012.0084.


5-fluorouracil (5-FU) is a key chemotherapeutic agent in the treatment of many gastrointestinal tract adenocarcinomas. Despite its proven therapeutic efficacy, 5-FU also possesses several undesired cardiac toxicities, including coronary vasospasm, coronary thrombosis, cardiomyopathy, and sudden cardiac death. This review addresses the incidence, mechanisms of action, clinical presentation, risk stratification, and management of 5-FU associated cardiotoxicity; it also highlights the importance of careful pre-administration cardiac risk stratification and close monitoring during and after drug administration.

Publication types

  • Review

MeSH terms

  • Animals
  • Antimetabolites, Antineoplastic / adverse effects*
  • Coronary Vessels / drug effects
  • Coronary Vessels / pathology
  • Drug Monitoring
  • Fluorouracil / adverse effects*
  • Heart Diseases / chemically induced*
  • Heart Diseases / diagnosis
  • Heart Diseases / mortality
  • Heart Diseases / therapy
  • Humans
  • Incidence
  • Myocardium / pathology
  • Risk Assessment
  • Risk Factors


  • Antimetabolites, Antineoplastic
  • Fluorouracil