Source : Elsevier Doyma

Acute myocardial infarction caused by heroin

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 intensity, without dysautonomia or dyspnea. Before the possibility of acute coronary syndrome, troponin 1 was requested. Whose initial result was 0.48 ng/ml (reference value: 0-0.3ng/ml). The initial electrocardiogram showed a ST drop in the anterolateral (fig. 2). The results of the echocardiogram ruled out abnormalities. Given the clinical and biochemical findings, an acute myocardial infarction with ST drop type 2 Killip-Kimball 1 was diagnosed, because of this vasodilator management with intravenous nitroglycerin was started at a low dose, along with dual anti-platelet therapy (clopidogrel and aspirin) and anticoagulation full with heparin at low molecular weight.