{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T20:27:35Z","timestamp":1746736055673,"version":"3.37.3"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T00:00:00Z","timestamp":1598227200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T00:00:00Z","timestamp":1598227200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Vasospastic angina is a rare but potentially life-threatening adverse event (AE) of S1, an oral fluoropyrimidine anticancer agent. However, this AE is not well known owing to its low incidence. We report herein a case of a patient who suffered from vasospastic angina associated with S1 chemotherapy for unresectable gastric adenocarcinoma, along with a review of the literature.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A 68-year-old woman was endoscopically diagnosed with gastric adenocarcinoma of the diffuse type. Abdominal pelvic contrast-enhanced computed tomography (CT) revealed small nodules in the omentum and ascites in the pouch of Douglas. The patient was clinically diagnosed with unresectable gastric adenocarcinoma with peritoneal metastasis, and primary chemotherapy with S1 plus cisplatin was selected. Around midnight of day 1, the patient complained of sudden oppressive chest pain. The pain disappeared spontaneously after 3\u20135\u2009min, but similar events happened every midnight thereafter. No significant change was found on bedside electrocardiograms (ECGs) recorded immediately after the pain attacks. The patient was suspected to have unstable angina and underwent Holter ECG on day 4 of treatment. Holter ECG revealed ST segment elevations and short-run ventricular tachycardia during a pain attack. S1 chemotherapy was discontinued, and no attack was observed thereafter. Coronary CT angiography showed no significant stenosis of coronary arteries.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Clinicians should be aware of vasospastic angina as a serious AE in the chemotherapy with S1. Holter ECG is useful for the early diagnosis of this rare and clinically important AE.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s40792-020-00975-x","type":"journal-article","created":{"date-parts":[[2020,8,24]],"date-time":"2020-08-24T11:03:02Z","timestamp":1598266982000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["S1-induced vasospastic angina\u2014diagnostic utility of Holter ECG: a report of a case"],"prefix":"10.1186","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6863-1587","authenticated-orcid":false,"given":"Tatsuo","family":"Kanda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsuhiro","family":"Wakai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tadasu","family":"Chida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuichi","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,8,24]]},"reference":[{"key":"975_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10120-016-0622-4","volume":"20","author":"Japanese Gastric Cancer Association","year":"2017","unstructured":"Japanese Gastric Cancer Association. Japanese gastric cancer treatment guidelines 2014 (ver. 4). Gastric Cancer. 2017;20:1\u201319.","journal-title":"Gastric Cancer"},{"key":"975_CR2","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1016\/0002-9343(87)90465-7","volume":"82","author":"NS Kleiman","year":"1987","unstructured":"Kleiman NS, Lehane DE, Geyer CE Jr, Pratt CM, Young JB. Prinzmetal\u2019s angina during 5-fluorouracil chemotherapy. Am J Med. 1987;82:566\u20138.","journal-title":"Am J Med"},{"key":"975_CR3","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1093\/annonc\/mdf035","volume":"13","author":"N Frickhofen","year":"2002","unstructured":"Frickhofen N, Beck FJ, Jung B, Fuhr HG, Andrasch H, Sigmund M. Capecitabine can induce acute coronary syndrome similar to 5-fluorouracil. Ann Oncol. 2002;13:797\u2013801.","journal-title":"Ann Oncol"},{"key":"975_CR4","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1016\/S0140-6736(75)91270-2","volume":"1","author":"RG Dent","year":"1975","unstructured":"Dent RG, McCall I. 5-Fluorouracil and angina. Lancet. 1975;1:347\u20138.","journal-title":"Lancet."},{"key":"975_CR5","first-page":"1705","volume":"34","author":"K Shitara","year":"2007","unstructured":"Shitara K, Kameda K, Hoshi Y, Munakata M, Muto O, Sakata Y. A case of suspected vasospastic angina related to S-1 administration. Gan To Kagaku Ryoho. 2007;34:1705\u20138.","journal-title":"Gan To Kagaku Ryoho"},{"key":"975_CR6","first-page":"568","volume":"4","author":"G Mariani","year":"2003","unstructured":"Mariani G, Giaccon G, Mastore M. Acute severe coronary spasm associated with initial first dose of 5-fluorouracil chemotherapy. Ital Heart J. 2003;4:568\u201370.","journal-title":"Ital Heart J"},{"key":"975_CR7","doi-asserted-by":"publisher","first-page":"441","DOI":"10.1007\/s10147-005-0516-7","volume":"10","author":"K Muneoka","year":"2005","unstructured":"Muneoka K, Shirai Y, Yokoyama N, Wakai T, Hatakeyama K. 5-Fluorouracil cardiotoxicity induced by alpha-fluoro-beta-alanine. Int J Clin Oncol. 2005;10:441\u20133.","journal-title":"Int J Clin Oncol"},{"key":"975_CR8","doi-asserted-by":"publisher","first-page":"342","DOI":"10.3904\/kjim.2012.27.3.342","volume":"27","author":"SM Kim","year":"2012","unstructured":"Kim SM, Kwak CH, Lee B, Kim SB, Sir JJ, Cho WH, et al. A case of severe coronary spasm associated with 5-fluorouracil chemotherapy. Korean J Intern Med. 2012;27:342\u20135.","journal-title":"Korean J Intern Med"},{"key":"975_CR9","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/s00280-005-0178-1","volume":"58","author":"SA Jensen","year":"2006","unstructured":"Jensen SA, S\u00f8rensen JB. Risk factors and prevention of the cardiotoxicity induced by 5-fluorouracil or capecitabine. Cancer Chemother Pharmacol. 2006;58:57\u201364.","journal-title":"Cancer Chemother Pharmacol"},{"issue":"1","key":"975_CR10","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1136\/bmj.1.6112.547","volume":"4","author":"A Pottage","year":"1978","unstructured":"Pottage A, Holt S, Ludgate S, Langlands AO. Fluorouracil cardiotoxicity. Br Med J. 1978;4(1):547.","journal-title":"Br Med J"},{"key":"975_CR11","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1254\/jjp.30.871","volume":"30","author":"I Matsubara","year":"1980","unstructured":"Matsubara I, Kamiya J, Imai S. Cardiotoxic effects of 5-fuluorouracil in the guinea pig. Jpn J Pharmacol. 1980;30:871\u20139.","journal-title":"Jpn J Pharmacol"},{"key":"975_CR12","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1253\/jcj.59.303","volume":"59","author":"Y Mizuno","year":"1995","unstructured":"Mizuno Y, Hokamura Y, Kimura T, Kimura Y, Kaikita K, Yasue H. A case of 5-fluorouracil cardiotoxicity simulating acute myocardial infarction. Jpn Circ J. 1995;59:303\u20137.","journal-title":"Jpn Circ J"},{"key":"975_CR13","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1200\/JCO.1989.7.4.509","volume":"7","author":"S Rezkalla","year":"1989","unstructured":"Rezkalla S, Kloner RA, Ensley J, Al-Sarraf M, Revels S, Olivenstein A, et al. Continuous ambulatory ECG monitoring during fluorouracil therapy: a prospective study. J Clin Oncol. 1989;7:509\u201314.","journal-title":"J Clin Oncol"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-020-00975-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-020-00975-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-020-00975-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,23]],"date-time":"2021-08-23T23:09:38Z","timestamp":1629760178000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-020-00975-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,24]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["975"],"URL":"https:\/\/doi.org\/10.1186\/s40792-020-00975-x","relation":{},"ISSN":["2198-7793"],"issn-type":[{"type":"electronic","value":"2198-7793"}],"subject":[],"published":{"date-parts":[[2020,8,24]]},"assertion":[{"value":"12 June 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 August 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 August 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for the publication of the case report and all accompanying images.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"217"}}