Qasim A, Townend J, Davies M K
Department of Cardiology, Queen Elizabeth Hospital, Edgbaston, Birmingham B29 6JD, UK.
Heart. 2001 Jun;85(6):E10. doi: 10.1136/heart.85.6.e10.
A 23 year old man presented with a clinical history and ECG compatible with acute myocardial infarction, having taken a single tablet of ecstasy (3,4-methylenedioxymetamphetamine) 18 hours previously. He was treated with aspirin and thrombolytic therapy; however, cardiac catheterisation showed angiographically normal coronary arteries and left ventricular function. Sympathomimetic drugs are freely available and widely abused in Britain, but there is little evidence of the mechanisms or management of cardiac complications. In such cases the use of standard treatment for acute myocardial infarction is recommended with agents such as glyceryl trinitrate and phentolamine to reduce coronary artery spasm. Early coronary angiography may help to determine the relative contribution of spasm, thrombus, and underlying atherosclerotic disease.
一名23岁男性，有与急性心肌梗死相符的临床病史及心电图表现，18小时前服用了一片摇头丸（3,4-亚甲基二氧甲基苯丙胺）。他接受了阿司匹林和溶栓治疗；然而，心导管检查显示冠状动脉造影正常且左心室功能正常。拟交感神经药物在英国可随意获取且滥用广泛，但关于心脏并发症的机制及处理几乎没有证据。在这类病例中，建议采用急性心肌梗死的标准治疗方法，使用硝酸甘油和酚妥拉明等药物以减轻冠状动脉痉挛。早期冠状动脉造影可能有助于确定痉挛、血栓及潜在动脉粥样硬化疾病的相对作用。
