Source: Revista Colombiana de Cardiología

Received September 17, 2013; Accepted March 10, 2014

Available on the Internet September 24, 2014

Heroin induced myocardial infarction

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

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. Given the possibility of acute coronary syndrome, troponin was requested, initially resulting in 0.48 ng/ml (reference value: 0-0.3 ng/ml). The electrocardiogram initially showed a ST elevation in the anterolateral side (fig. 2). The result of the electrocardiogram dismissed abnormalities. Given the clinical and biochemical discoveries, the patient was diagnosed with acute myocardial infarction with a ST elevation type two, Killip-Kimball I, therefore vasodilator with intravenous nitroglycerin in low dosages, along with dual antiplatelet therapy(clopidogrel and aspirin), and full anticoagulation with heparin of low molecular weight were imitated.