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空气清新剂吸入性滥用导致非ST段抬高型心肌梗死

Air Duster Inhalant Abuse Causing Non-ST Elevation Myocardial Infarction.

作者信息

Cao Shiliang A, Ray Madhab, Klebanov Nikolai

机构信息

Anesthesiology, Massachusetts General Hospital, Boston, USA.

Internal Medicine, Signature Healthcare Brockton Hospital, Brockton, USA.

出版信息

Cureus. 2020 Jun 1;12(6):e8402. doi: 10.7759/cureus.8402.

Abstract

Inhalant abuse, also known as huffing, is common among teenagers and adolescents in the United States and worldwide. Inhaled aerosols are dangerous due to both the presence of volatile hydrocarbons causing direct organ damage and the risk of the compressed air causing physical trauma (e.g. expansion, barotrauma) or skin trauma from chemical or temperature burn. Here, we present the case of a 35-year-old man who was inhaling multiple canisters of Dust-Off (Falcon Safety Products Inc., Branchburg, NJ) keyboard air duster daily for approximately one month. He presented with intermittent burning chest pains, and was found to have elevated troponin (peak 17 ng/mL, normal range 0-0.5 ng/mL) without ST-segment elevations, concerning for non-ST elevation myocardial infarction (NSTEMI) as well as elevated aminotransferases and elevated serum creatinine. He was treated conservatively with supportive measures, with successful resolution of his laboratory abnormalities as well as his chest pain. Clinicians should be aware of the possible medical complications of inhalant abuse, and the expected clinical course. In this case, we aim to demonstrate the acute onset and self-resolution of significant cardiomyocyte damage in a young male patient abusing duster.

摘要

吸入剂滥用,也称为嗅吸,在美国和全球的青少年中都很常见。吸入气雾剂很危险,这是因为其中存在的挥发性碳氢化合物会导致直接的器官损伤,以及压缩空气造成身体创伤(如膨胀、气压伤)或因化学或温度灼伤导致皮肤创伤的风险。在此,我们报告一例35岁男性病例,他每天吸入多罐Dust-Off(新泽西州布兰奇堡的猎鹰安全产品公司)键盘清洁气雾剂,持续约一个月。他出现间歇性胸痛,肌钙蛋白升高(峰值17 ng/mL,正常范围0 - 0.5 ng/mL),但无ST段抬高,疑似非ST段抬高型心肌梗死(NSTEMI),同时伴有转氨酶升高和血清肌酐升高。他接受了保守的支持性治疗,实验室异常指标以及胸痛症状均成功缓解。临床医生应意识到吸入剂滥用可能导致的医学并发症以及预期的临床病程。在本病例中,我们旨在展示一名滥用清洁气雾剂的年轻男性患者中显著心肌细胞损伤的急性发作和自行缓解情况。

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