Anesthesiology and Intensive Care Department, P. L. Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine.
State Institution "Heart Institute Ministry of Health of Ukraine", Kyiv, Ukraine.
Cardiovasc Toxicol. 2020 Oct;20(5):520-524. doi: 10.1007/s12012-020-09575-5.
The article reveals about the clinical accident of myocardial infarction in an adolescent after visiting a night club, where he had been drinking tequila. A "sniper" test was performed at home and showed synthetic marihuana in urine. The uniqueness of this case is the adolescent's difficult premorbid condition (severe diabetes mellitus type 1 and sub-compensated hypothyreosis) and the clinical course of the disease had caused difficulty in diagnosis which led to a belated hospitalization on the third day. Considering pain syndrome, infarction-like findings in ECG (ST elevation), high levels of cardiospecific enzymes (troponin elevated 70 times, aspartate aminotransferase-two times, creatine phosphokinase-4 times, lactate dehydrogenase and alkaline phosphatase-two times) and their slow tendency to normalize-a non-Q myocardial infarction diagnosis was performed. After complex treatment, the general condition of the patient improved; he was discharged from the clinic in satisfactory general condition and was given recommendations for further rehabilitation. Given the potential for premature death and long-term disability with the development of negative individual and social consequences, the correct diagnostic assessment in such cases becomes particularly relevant.
这篇文章揭示了一名青少年在夜总会喝酒后出现心肌梗死的临床事故。在家中进行了“狙击手”测试，尿液中显示出合成大麻素。这个病例的独特之处在于青少年的困难前期病情（1 型严重糖尿病和亚补偿性甲状腺功能减退症），以及疾病的临床过程导致诊断困难，导致第三天住院延迟。考虑到疼痛综合征、心电图（ST 段抬高）的梗塞样表现、心脏特异性酶的高水平（肌钙蛋白升高 70 倍，天冬氨酸氨基转移酶升高 2 倍，肌酸磷酸激酶升高 4 倍，乳酸脱氢酶和碱性磷酸酶升高 2 倍）及其缓慢的正常化趋势，诊断为非 Q 型心肌梗死。经过综合治疗，患者的一般情况有所改善；他在一般情况满意的情况下出院，并获得了进一步康复的建议。鉴于潜在的早逝和长期残疾以及负面的个人和社会后果，在这种情况下进行正确的诊断评估变得尤为重要。
