ADULT CARDIOLOGY- CASE STUDIES

Heroin-Induced Acute Myocardial Infarction

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

Department of Critical Care Medicine and Intensive Care, University Hospital Foundation Santa Fe de Bogota, Bogota, Colombia.

Department of Internal Medicine, Section of Cardiology, University Hospital Foundation Santa Fe de Bogota, Bogota, Colombia.

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

Available online on September 24, 2014.

Airway support and naloxone treatment were initiated due to signs of opioid intoxication and imminence of respiratory failure. In the emergency care, the patient indicated not irradiated localized precordial pain. The patient faced the possibility of acute coronary syndrome. Troponin I was requested, whose initial results were 0.48ng/ml (reference value: 0-0.3 ng /ml). The initial electrocardiogram showed ST segment elevation in the anterolateral. The result of echocardiography presents no abnormalities. Based on the clinical and biochemical findings, acute myocardial infarction was diagnosed with ST elevation type 2, Killip-Kimball, which it was controlled with vasodilator management low dose intravenous nitroglycerin, dual antiplatelet therapy (Clopidogrel and aspirin), and full anticoagulation with low heparin molecular weight.