Revista Colombiana de Cardiología

www.elsevier.es/revcolcar

ADULT CARDIOLOGY – CASE PRESENTATION

Heroin-Induced Myocardial Infarction

Beatriz Wills[a] *, Andrés F. Buitrago[b]a,b,*, Nohra P. Romeroa,b y Mariana Soto 

[a] Department of Critical Medicine and Intensive Care, Foundation Santa Fe de Bogotá University Hospital, Bogotá, Colombia

[b] Department of Internal Medicine, Cardiology Section, Foundation Santa Fe de Bogotá University Hospital, Bogotá, Colombia

*Author for correspondence

Email: [email protected] (A.F. Buitrago)

Received September 17, 2013; accepted March 10, 2014

Available online by September 24, 2014

Due to signs of opioid intoxication and the imminence of respiratory failure, airway support and naloxone treatment were initiated. During emergency care the patient indicated localized precordial pain, of moderate intensity, without dyspnea. In view of possible acute coronary syndrome, the patient was administered troponin I, which it’s initial result was 0.48 ng/ml (reference value: 0-0.3 ng/ml). The initial echocardiogram revealed supra-uneven ST anterolateral face (fig. 2). The echocardiogram results dismissed abnormalities. According to the clinical and biochemical findings, the patient was diagnosed acute myocardial infarction with elevation on the ST type 2, Killip Kimball I. Therefore, low doses of vasodilation with nitroglycerin through IV, dual anti-aggregation therapy (Clopidogrel and aspirin), and full anticoagulation with heparin of low molecular mass were initiated.