skip to main content

Cardiotoxicity — SCE Medical Oncology MCQ

Instant feedback + full explanation. One question, done properly.

HardOncological EmergenciesCardiotoxicitySCE Medical Oncology

Thirty minutes into a continuous 5-fluorouracil infusion, a patient develops crushing chest pain with inferior ST elevation. The first high-sensitivity troponin is normal. What is the safest immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Stop fluorouracil, initiate urgent ACS assessment and administer nitrates during clinical evaluation

The temporal association strongly suggests fluoropyrimidine coronary vasospasm, but an initial normal troponin does not exclude acute coronary occlusion. The immediate priorities are stopping 5-FU and urgent ACS evaluation; nitrates and/or calcium-channel blockade are used when vasospasm is suspected. The previous explanation overinterpreted the first troponin.

Reference: Fluorouracil 50 mg/mL UK summary of product characteristics (Current UK SmPC, accessed August 2026): https://www.medicines.org.uk/emc/product/2234/smpc; ESC guideline on cardio-oncology (Published August 2022): https://www.escardio.org/guidelines/clinical-practice-guidelines/all-esc-practice-guidelines/cardio-oncology/