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Interestingly, cardiac MRI scan 9\u2005days later showed a normal LVEF with signs of neither myocardial oedema nor necrosis. Despite the high therapeutic efficacy of 5-FU in treatment of colorectal cancer, it is associated with undesired cardiac toxicities including coronary spasms, toxic inflammation and takotsubo cardiomyopathy. However, our patient did not fulfil the diagnostic criteria for the aforementioned complications. Based on this case report, we discuss alternative mechanisms including myocardial adenosine triphosphate depletion suggested from animal experiments.<\/jats:p>","DOI":"10.1136\/bcr-2015-213783","type":"journal-article","created":{"date-parts":[[2016,6,1]],"date-time":"2016-06-01T20:06:24Z","timestamp":1464811584000},"page":"bcr2015213783","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["5-Fluorouracil-induced acute reversible heart failure not explained by coronary spasms, myocarditis or takotsubo: lessons from MRI"],"prefix":"10.1136","volume":"2016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3374-4781","authenticated-orcid":false,"given":"Yama","family":"Fakhri","sequence":"first","affiliation":[{"name":"Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark"},{"name":"Department of Medicine, Division of Cardiology, Nyk\u00f8bing F Hospital, Copenhagen University Hospital, Nyk\u00f8bing F, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morten","family":"Dalsgaard","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorte","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Oncology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Per","family":"Lav Madsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2016,6,1]]},"reference":[{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.1","doi-asserted-by":"publisher","DOI":"10.1186\/2050-6511-15-47"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2005.10.013"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-005-0159-8"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.4","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.carrev.2012.10.001","article-title":"Capecitabine caused cardiogenic shock through induction of global Takotsubo syndrome","volume":"14","author":"Y-Hassan","year":"2013","journal-title":"Cardiovasc Revasc Med"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.5","doi-asserted-by":"publisher","DOI":"10.1272\/jnms.76.27"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.6","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeu004"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.7","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.992"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.8","doi-asserted-by":"publisher","DOI":"10.1186\/1532-429X-13-67"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.9","doi-asserted-by":"publisher","DOI":"10.1177\/0267659111410347"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.10","doi-asserted-by":"publisher","DOI":"10.1097\/MBC.0b013e3283597605"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.11","doi-asserted-by":"publisher","DOI":"10.1097\/00000441-198710000-00004"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.12","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200010000-00038"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.13","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.38.5278"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.14","first-page":"819396","article-title":"Acute cardiogenic shock induced by infusional 5-fluorouracil","volume":"2014","author":"Sulpher","year":"2014","journal-title":"Case Rep Oncol Med"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.15","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/28.9.551"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.tcm.2014.11.005"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2007.11.008"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1406761"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.06.094"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.20","doi-asserted-by":"publisher","DOI":"10.1254\/jjp.30.871"},{"key":"2025082703082488000_2016.jun01_4.bcr2015213783.21","first-page":"805","article-title":"The appearance of endothelium in small arteries after treatment with 5-fluorouracil. 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