Revista Colombiana de Cardiología

ADULT CARDIOLOGY – CASE STUDY 

Acute myocardial infarction induced by heroin

Beatriz Wills^a , Andrés F. Buitrago^a,b, Nohra P. Romero^a,b and Mariana Soto^a  

^aDepartment of critical medicine and intensive care, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia

^bDepartment of internal medicine, section of Cardiology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia

Received on September 17, 2013; accepted on March 10, 2014; available online on September 24, 2014

Due to the signs of poisoning by opiates and its possible link to respiratory failure, support of the airways and treatment with naloxone have been started. During emergency treatment in the ER, the patient reported chest pains, non-irradiated and of moderate intensity, without dysautonomia nor dyspnea. Due to the fear of the patient experiencing acute coronary syndrome, troponin I was administered, its initial result was 0.48 ng/ml (reference value: 0-0.3 ng/ml). The initial electrocardiogram showed abnormalities in the ST at the anterolateral side (fig. 2). The result of the Echocardiogram ruled out abnormalities. Given the clinical and biochemical findings, the patient was diagnosed with acute ST-elevation myocardial infarction type2, Killip – Kimball I, for which a treatment to handle vasodilation was administered; with low doses of intravenous nitroglycerin, dual antiplatelet therapy (clopidogrel and aspirin), and full anticoagulation with heparin of low molecular weight.