William Cardona

SPA 4003

December 10, 2015

Revista Colombiana de Cardiologia

Heroin-Induced Acute Myocardial Infarction

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

 (a) Department of Intensive and Critical Care Medicine, Hospital Universitario Fundación Santa de Fe de Bogotá, Bogotá, Colombia

(b) Department of Internal Medicine, Cardiology Section, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia

Received September 17, 2013; accepted March 10, 2014. Web publication September 24, 2014

Heroin-induced myocardial infarction

Due to the symptoms of opioid intoxication and imminence of respiratory failure, a management began with airway support and management with naloxone.

During emergency care the patient indicated chest pain not irradiation, of moderate intensity, without dysautonomia or dyspnea. Given the possibility of coronary syndrome, troponin was used, with the initial results being 0.48ng/ml (reference value: 0- 0.3 ng/ml)

The initial electrocardiogram indicated St Elevation of the St on the anterolateral side (fig.2). The result of the echocardiogram ruled out abnormalities.

Due to the clinical and biochemical findings, the diagnose was acute myocardial infarction with ST-Elevation type 2, Killip-Kimball, by which a vasodilator was initiated with nitroglycerin via intravenous at low dose, Antiplatelet therapy dual (Clopidogrel and aspirin) and full anticoagulation with low molecular weight heparin.