Shah R, Duncan S J, Ramanathan K B
Section of Cardiology, University of Tennessee School of Medicine, Section of Cardiovascular Medicine Veterans Affairs Medical Center, 1030 Jefferson Avenue, Memphis TN, USA.
Section of Cardiology, University of Tennessee School of Medicine, Memphis TN, USA.
Acute Med. 2014;13(2):72-3.
Use of cocaine may complicate the diagnosis of myocardial infarction (MI) and may influence treatment strategy. Patients with symptoms suggestive of acute coronary syndrome (ACS) should be questioned about the use of cocaine. Initial management of cocaine users presenting with chest pain and ST segment elevation should include administration of glyceryl trinitrate (GTN). Assessment for resolution of chest discomfort and ECG changes should be undertaken before fibrinolytic therapy or angiography is considered. We present a case of patient with chest pain (CP) and ST elevation after cocaine use, whose symptoms and ST changes promptly resolved after medical therapy. Our case highlights the importance of medical therapy in patient with CP and ST elevation after cocaine abuse, before activating cardiac catheterization laboratory for emergent angiography.
使用可卡因可能会使心肌梗死（MI）的诊断复杂化，并可能影响治疗策略。对于有急性冠状动脉综合征（ACS）症状的患者，应询问其是否使用过可卡因。出现胸痛和ST段抬高的可卡因使用者的初始治疗应包括给予硝酸甘油（GTN）。在考虑进行纤溶治疗或血管造影之前，应评估胸痛不适和心电图变化是否缓解。我们报告一例使用可卡因后出现胸痛（CP）和ST段抬高的患者，其症状和ST段变化在药物治疗后迅速缓解。我们的病例强调了在因可卡因滥用出现CP和ST段抬高的患者中，在启动心脏导管实验室进行紧急血管造影之前，药物治疗的重要性。
