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Cardiotoxicity is a rare but very serious side effect of 5-fluorouracil (5-FU) treatment. Many theories have been suggested to explain the mechanism of this problem. Most commonly, coronary artery spasm is considered responsible in cardiovascular toxicity. Ischemic symptoms and signs related to 5-FU therapy are observed during the late phase of the administration of the drug. The close and careful monitoring of all patients, especially the ones with pre-existent coronary artery disease, during 5-FU infusion is mandatory. Because there is not a single and effective modality of prevention of 5-FU cardiotoxicity, the patients should be selected carefully for its administration, 5-FU infusion should be stopped as soon as symptoms are encountered. A case of a 58-year-old woman treated with 5-FU due to colon cancer is described. In the late phase of 5-FU administration, the patient developed anginal pain with transitional ST segment elevation in ECG. Patient, after coronary angiography, was successfully treated with percutaneous coronary intervention. Interventional methods, most of all stent implantation, seem to be the best treatment of 5-FU-related acute coronary syndromes.

It's known that common risk factors of atherosclerosis can explain only 50% of its etiology. In only 40% patients risk factors modification inhibits progression of atherosclerosis. Therefore looking for new risk factors of atherosclerosis is necessary. In recent years the inflammatory-infectious hypothesis of atherosclerosis has been reevaluated. The discovery of heavy infections load in the serum of patients with acute coronary syndromes might suggest a potential immunological mechanism triggered by bacterial proteins. Chlamydia pneumoniae, Helicobacter pylori and cytomegalovirus infections are very common in human population and therefore they are suspected as the main infectious pathogen in the coronary disease. Clinical studies have demonstrated higher anti-Chlamydia and ani-Helicobacter antibody titres in patients with myocardial infarction (60-70% pts), stable and unstable angina (50-60% pts) than in control groups (12-15% pts). Two studies were performed with antibiotic (azotromycin, roxitromycin) influence on the prevalence of acute coronary syndromes after myocardial infarction and unstable angina. These studies have shown statistically significant reduction of the prevalence of acute coronary episodes in follow-up period.