[Acute myocardial infarct following chemotherapy for testicular carcinoma: on the coronary toxicity of cytostatic agents].

Two young patients who had been treated with cisplatin and bleomycin for testicular cancer developed acute myocardial infarction. 8 additional cases of premature myocardial infarction following chemotherapy for testicular cancer have been reported in the literature. The infarctions occurred several months or years after chemotherapy while most patients were in complete remission and had no significant risk factors for coronary artery disease. However, the pathogenesis of the assumed coronary toxicity associated with antineoplastic agents, usually with cisplatin and bleomycin, is not well understood; lesions of the endothelium with obstructive coronary fibrosis as well as disorders of the clotting system and coronary vasospasm have been considered as possibilities. We conclude that in patients treated for testicular cancer, special attention should be paid to symptoms suggestive of coronary artery disease.