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复发性心肌心包炎作为大麻使用的一种并发症。

Recurrent myopericarditis as a complication of Marijuana use.

作者信息

Rodríguez-Castro Carlos E, Alkhateeb Haider, Elfar Ahmed, Saifuddin Fatima, Abbas Aamer, Siddiqui Tariq

机构信息

Department of Internal Medicine, Texas Tech University Health Science Center, El Paso, TX, U.S.A.

Department of Internal Medicine, Jinnah Postgraduate Medical Centre, Karachi, Pakistan.

出版信息

Am J Case Rep. 2014 Feb 5;15:60-2. doi: 10.12659/AJCR.889808. eCollection 2014.

DOI:10.12659/AJCR.889808
PMID:24523950
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3921097/
Abstract

PATIENT

Male, 29 FINAL DIAGNOSIS: Myopericarditis Symptoms: Chest pain Medication: Ibuprofen Clinical Procedure: - Specialty: Cardiology.

OBJECTIVE

Unusual clinical course.

BACKGROUND

Cannabis is the most commonly used illegal substance worldwide and its consumption portends significant side effects. Nowadays, in order to increase its psychotropic effect, various substances are being added constantly to it to promote its potency that might hold toxic effects to different organs including the heart and might lead to other unreported complications such as myopericarditis. Herein, we are presenting a unique case of recurrent myopericarditis after the consumption of contaminated marijuana, an association that has not been reported in literature before.

CASE REPORT

A 29-year-old man presented to our institution with pressure-like left-sided chest pain that is aggravated by cough and deep inspiration and relieved by sitting and leaning forward. Examination revealed pericardial rub and workup showed elevated white blood cell count, C-reactive protein and troponin I level of 2.99 ng/ml. ECG upon admission showed ST-segment elevation in the inferior leads with PR-segment depression. Echocardiogram revealed only concentric hypertrophy. PATIENT was admitted to another institution with similar symptoms 2 months earlier. PATIENT admitted to using adulterated Marijuana on both occasions prior to hospitalization. Review of medical records from the outside hospital revealed similar ECG and laboratory findings. Treatment with Ibuprofen resulted in resolution of patient's symptoms and ECG abnormalities.

CONCLUSIONS

Recurrent myopericarditis in our patient is likely the result of consumption of contaminated Marijuana. Careful history taking in patients presenting with myopericarditis is crucial as it might be the causal link.

摘要

患者

男性,29岁 最终诊断:心肌心包炎 症状:胸痛 用药:布洛芬 临床操作:- 专科:心脏病学。

客观情况

不寻常的临床病程。

背景

大麻是全球最常用的非法物质,其使用会带来显著的副作用。如今,为了增强其精神作用,不断有各种物质被添加到其中以提高其效力,这可能对包括心脏在内的不同器官产生毒性作用,并可能导致其他未报告的并发症,如心肌心包炎。在此,我们报告一例食用受污染大麻后复发性心肌心包炎的独特病例,此前文献中尚未报道过这种关联。

病例报告

一名29岁男性因左侧胸部出现类似压榨性的疼痛前来我院就诊,咳嗽和深吸气会加重疼痛,坐起并前倾时疼痛缓解。检查发现有心包摩擦音,检查结果显示白细胞计数、C反应蛋白升高,肌钙蛋白I水平为2.99纳克/毫升。入院时心电图显示下壁导联ST段抬高,PR段压低。超声心动图仅显示同心性肥厚。该患者在2个月前因类似症状入住另一家机构。患者承认在两次住院前均使用了掺假的大麻。查阅外院的病历记录发现了类似的心电图和实验室检查结果。使用布洛芬治疗后患者症状和心电图异常得以缓解。

结论

我们这位患者的复发性心肌心包炎可能是食用受污染大麻的结果。对于出现心肌心包炎的患者,仔细询问病史至关重要,因为这可能是因果联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2f8/3921097/fa79fdfd7fb2/amjcaserep-15-60-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2f8/3921097/8f709c0d7f27/amjcaserep-15-60-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2f8/3921097/fa79fdfd7fb2/amjcaserep-15-60-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2f8/3921097/8f709c0d7f27/amjcaserep-15-60-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d2f8/3921097/fa79fdfd7fb2/amjcaserep-15-60-g002.jpg

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本文引用的文献

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A review of the world cannabis situation.全球大麻形势综述。
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Cannabis potency and contamination: a review of the literature.大麻效力与污染:文献综述
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Cardiovascular complications of recreational drugs.消遣性药物的心血管并发症。
29岁医用大麻成瘾男子出现伴有心脏骤停和心肌梗死的阵发性持续性室性心动过速——祸不单行。
Healthcare (Basel). 2022 Oct 13;10(10):2024. doi: 10.3390/healthcare10102024.
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