Capecitabine-Associated Coronary Vasospasm and Cardiac Arrest

Capecitabine is a prodrug of fluorouracil that specifically targets cancer cells, commonly used as monotherapy for metastatic breast and colorectal cancer. Its side effects include nausea, diarrhea, vomiting, abdominal pain, anorexia, palmar-plantar erythrodysesthesia, anemia, and hyperbilirubinemia. Rarely, this chemotherapy agent has been associated with cardiotoxicity, including cardiac arrest, likely secondary to coronary vasospasm. This case report serves to highlight the unfortunate case of a 32-year-old female who suffered a ventricular fibrillation cardiac arrest three days after initiating capecitabine therapy.