Adverse cardiovascular events have been reported in patients with
multiple myeloma. We present a case of coronary
spastic angina during combination
therapy with
bortezomib,
lenalidomide, and
dexamethasone for
multiple myeloma. A 70-year-old man, newly diagnosed with
multiple myeloma, was admitted to our hospital at his fifth
therapy cycle due to exertional
chest pain. Coronary angiography revealed diffuse
spasm in the left coronary artery, which normalized after intracoronary injection of
nitroglycerin.
Calcium channel blockers were effective in treating his coronary
spastic angina and the patient resumed treatment for
multiple myeloma. This case highlights the importance of being aware of the possibility of coronary
spastic angina when combination
therapy with
bortezomib,
lenalidomide, and
dexamethasone is initiated. <Learning objective: Combination
therapy with
bortezomib,
lenalidomide, and
dexamethasone has improved overall survival of
multiple myeloma patients. However, these drugs can induce coronary
spastic angina.
Calcium channel blockers may be effective for coronary
spastic angina and allow patients to continue
multiple myeloma treatment.>.