Heroin-induced myocardial infarction

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

 Received on September 17, 2013; accepted on March 10, 2014

Available online on September 24, 2014

Due to signs of opioid intoxication and imminence of respiratory failure, airway and naloxone treatment were initiated. During emergency care the patient indicated localized precordial pain without dysautonomia or dyspnea. Given the possibility of acute coronary syndrome, we requested troponin I, which initial result was 0.48 ng/ml (reference value: 0- 0.3 ng/ml). The initial electrocardiogram showed upsloping ST elevation on the front anterolateral (fig. 2). The result of the Echocardiogram ruled out abnormalities. Due to clinical and biochemical findings, the patient was diagnosed with acute myocardial infarction with ST-Elevation type 2, Killip-Kimball I, therefore low doses of vasodilator with intravenous nitroglycerin, anti dual aggregation (clopidogrel and aspirin) and full anticoagulation with heparin of low weight molecular were administered on the patient.