Source: Department of Intensive and Critical Care Medicine, Hospital Universitario Fundación Santa de Fe de Bogotá, Bogotá, Colombia

Heroin- induced myocardial infarction

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

Received on September 17th, 2013

Received on March 10th 2014

Available online on September 24th, 2014

Due to the symptoms of opioid intoxication and imminence of respiratory failure, a treatment of air support and naloxone were initiated. During emergency care, the patient indicated precordial pain of moderate intensity, without dysautonomia or dyspnea. Given the possibility of acute coronary syndrome, a troponin I test was requested, with initial result of 0.48ng/ml  (reference value = 0-0.3ng/ml).The initial electrocardiogram indicated St segment elevation on the anterolateral side(Fig.2). The electrocardiogram results ruled out abnormalities. Given the clinical and biochemical findings, acute myocardial infarction with St- elevation type 2 , Killip-Kimball was diagnosed, by which the use of vasodilator with low doses of intravenous nitroglycerin was initiated, along with dual antiplatelet therapy (clopidogrel and aspirin), and full anticoagulation with low molecular weight heparin.