Rodríguez-Castro Carlos E, Alkhateeb Haider, Elfar Ahmed, Saifuddin Fatima, Abbas Aamer, Siddiqui Tariq
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.
Am J Case Rep. 2014 Feb 5;15:60-2. doi: 10.12659/AJCR.889808. eCollection 2014.
Male, 29 FINAL DIAGNOSIS: Myopericarditis Symptoms: Chest pain Medication: Ibuprofen Clinical Procedure: - Specialty: Cardiology.
Unusual clinical course.
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.
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.
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.
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。
不寻常的临床病程。
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。
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。
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。