Revista Colombiana de Cardiología

ADULT CARDIOLOGY — CASE STUDIES

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.

…Due to signs of opioid overdose and imminent respiratory failure, airway support and naloxone treatment were initiated. During emergency care, the patient indicated localized precordial pain of moderate intensity, with no dysautonomia or dyspnea. Given the possibility of acute coronary syndrome, troponin I was requested, with an initial result of 0.48 ng/ml (reference value: 0-0.3 ng/ml). The initial electrocardiogram showed ST segment elevation in the anterolateral leads (fig. 2). An echocardiogram revealed no abnormalities. Given the clinical and biochemical findings, type 2 acute MI with ST segment elevation, Killip-Kimball I, was diagnosed. Vasodilator treatment was initiated with low-dose intravenous nitroglycerin, dual antiplatelet therapy (Clopidogrel and aspirin) and full anticoagulation with low molecular weight heparin.