Abstract Background 5-fluorouracil (5-FU) is a widely used chemotherapy agent in gastrointestinal (GI) malignancies, but it can cause cardiotoxicity, most commonly manifesting as chest pain due to coronary vasospasm, often mimicking acute coronary syndrome. Adequate management of 5-FU-associated vasospasm is critical to ensure the necessary oncological treatment can be safely continued. Objectives The aim of this study was the retrospective analysis of cases of chest pain associated with intravenous 5-FU treatment in GI cancer patients at a single institution, and to report the experiences with antianginal treatment, specifically nitrates and calcium channel blockers, administered in these cases. Methods This was a retrospective, single-center, observational cohort study. We analyzed data of GI cancer patients treated with intravenous 5-FU between March 2024 and August 2025 who experienced chest pain during treatment. Following the institutional protocol, the chemotherap
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