{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T05:29:34Z","timestamp":1783661374512,"version":"3.55.0"},"reference-count":13,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,2,26]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:p>A 40-year-old man presented to a local hospital with a 2-day history of dyspnoea having been started on adjuvant chemotherapy consisting of oxaliplatin and capecitabine for mucinous adenocarcinoma of the colon. During his admission, he develops chest pain, worsening shortness of breath, and intermittent dysarthria and disorientation. Investigations reveal severely impaired left ventricular function on echocardiogram, bilateral acute pulmonary embolisms on CT pulmonary angiogragraphy, and diffused subcortical and callosal white matter signal change and restricted diffusion consistent with a toxic leukoencephalopathy on MRI of brain. This case highlights the pivotal role of the multidisciplinary cardio-oncology approach which enabled these challenging diagnoses to be made and ensured optimal patient outcome.<\/jats:p>","DOI":"10.1136\/bcr-2020-239560","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T11:41:21Z","timestamp":1615808481000},"page":"e239560","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Treating the treatment: chemotherapy-induced multi-organ toxicity"],"prefix":"10.1136","volume":"14","author":[{"given":"Sara","family":"Tyebally","sequence":"first","affiliation":[{"name":"Cardio-Oncology Service, Barts Health NHS Trust, London, UK"},{"name":"Cardio-Oncology Service, The Hatter Cardiovascular Institute, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aderonke","family":"Abiodun","sequence":"additional","affiliation":[{"name":"Cardio-Oncology Service, Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Slater","sequence":"additional","affiliation":[{"name":"Cardio-Oncology Service, Barts Health NHS Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun K","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Cardio-Oncology Service, Barts Health NHS Trust, London, UK"},{"name":"Cardio-Oncology Service, The Hatter Cardiovascular Institute, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,3,15]]},"reference":[{"key":"2025082722580791000_14.3.e239560.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)33326-3"},{"key":"2025082722580791000_14.3.e239560.2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.33.6297"},{"key":"2025082722580791000_14.3.e239560.3","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyq069"},{"key":"2025082722580791000_14.3.e239560.4","doi-asserted-by":"crossref","first-page":"89","DOI":"10.15420\/icr.2019.12","article-title":"Coronary artery vasospasm induced by 5-fluorouracil: proposed mechanisms, existing management options and future directions","volume":"14","author":"Chong","year":"2019","journal-title":"Interv Cardiol"},{"key":"2025082722580791000_14.3.e239560.5","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2008.060574"},{"key":"2025082722580791000_14.3.e239560.6","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.17.1637"},{"key":"2025082722580791000_14.3.e239560.7","first-page":"1783","article-title":"Capecitabine-Induced cardiotoxicity: more evidence or clinical approaches to protect the patients' heart?","volume":"7","author":"Fontanella","year":"2014","journal-title":"Onco Targets Ther"},{"key":"2025082722580791000_14.3.e239560.8","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1200\/JCO.1992.10.11.1795","article-title":"Cardiotoxicity of high-dose continuous infusion fluorouracil: a prospective clinical study","volume":"10","author":"de Forni","year":"1992","journal-title":"J Clin Oncol"},{"key":"2025082722580791000_14.3.e239560.9","doi-asserted-by":"publisher","DOI":"10.1517\/14740330902733961"},{"key":"2025082722580791000_14.3.e239560.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0959-8049(01)00413-0"},{"key":"2025082722580791000_14.3.e239560.11","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.04.2150"},{"key":"2025082722580791000_14.3.e239560.12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc0911925"},{"key":"2025082722580791000_14.3.e239560.13","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1177\/1078155217739686","article-title":"Acute reversible toxic encephalopathy during capecitabine and oxaliplatin treatment","volume":"25","author":"Godinho","year":"2019","journal-title":"J Oncol Pharm Pract"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-239560","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T05:58:13Z","timestamp":1756360693000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-239560"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":13,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,3,15]]},"published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1136\/bcr-2020-239560"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-239560","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3]]}}}