An unusual case of acute myopericarditis after the first dose of capecitabine: Need for new cardioprotective strategies and risk stratification.

BACKGROUND Fluoropyrimidines 5-fluorouracil (5-FU) and capecitabine are antimetabolite drugs used for the treatment of colorectal, breast, head, and neck malignancies. Different clinical manifestations of fluoropyrimidine-induced cardiotoxicity (FIC) have been reported in the literature. CASE REPORT A 46-year-old female patient with a history of colorectal adenocarcinoma presented to the Emergency Department due to chest pain and mildly elevated cardiac serum troponin levels. Three days earlier, she had received a first adjuvant chemotherapy treatment with oral capecitabine. After the exclusion of obstructive coronary artery disease (CAD), acute myopericarditis was suspected. CONCLUSION Capecitabine-induced myopericarditis is an extremely rare but important clinical condition to be recognized and treated promptly in order to prevent potentially lethal consequences of cardiac dysfunction.