Source: Revista Colombiana de Cardiología

Heroin-induced myocardial infarction

Beatriz Wills, Andrés F. Buitrago, Nohra P. Romero, Mariana Soto

Received 17 September 2013
Accepted 10 March 2014
Available online 24 September 2014

Due to signs of opioid intoxication and imminence of respiratory failure, airway support and naloxone treatment were initiated. During emergency care, the patient indicated localized precordial pain of moderate to severe intensity, without dysautonomia or dyspnea. Faced with the possibility of acute coronary syndrome, a troponin I test was requested initially resulting in 0.48 ng/ml (reference value= 0-0.3 ng/ml). The initial electrocardiogram revealed ST segment elevation in the anterolateral part of the face (Fig. 2). The electrocardiogram results ruled out abnormalities. Given the clinical and biochemical findings, acute myocardial infarction of Type II ST segment elevation, Killip-Kimball I, was diagnosed, for which the use vasodilator with low doses of intravenous nitroglycerin, dual antiplatelet therapy (clopidogrel and aspirin), and full anticoagulation with low molecular weight heparin were initiated.