Nasrallah Rabih, Ossaily Amin, Al Hammoud Mazen, Nader Anwar, Ghanem Georges
Cardiology, Lebanese American University School of Medicine, Beirut, LBN.
Cardiology, Lebanese American University Medical Center, Beirut, LBN.
Cureus. 2025 Jun 11;17(6):e85795. doi: 10.7759/cureus.85795. eCollection 2025 Jun.
Ecstasy, also known as 3,4-methylenedioxymethamphetamine (MDMA), is widely used as a recreational drug known for its stimulating effects. While acute coronary syndrome and coronary vasospasm are frequently observed following cocaine and methamphetamine use, there have been few reported cases linking them to ecstasy use. We present a case of a 27-year-old, previously healthy, male presenting with oppressive retrosternal chest pain and diffuse ST-segment elevation, despite a normal troponin, several days after ecstasy use. His presentation followed by a normal coronary angiography is most consistent with an episode of coronary vasospasm. It is plausible that the consumption of MDMA contributed to this presentation. MDMA can lead to cardiovascular issues by increasing serotonin, dopamine, and noradrenaline levels, which may cause symptoms like coronary vasospasm. Although conclusive evidence linking MDMA to acute coronary syndrome is limited, cases of transient coronary vasospasm and thrombosis have been reported, suggesting a need for prompt evaluation and management of such conditions.
摇头丸，又称3,4-亚甲基二氧甲基苯丙胺（MDMA），作为一种以刺激作用闻名的娱乐性药物被广泛使用。虽然在使用可卡因和甲基苯丙胺后经常观察到急性冠状动脉综合征和冠状动脉痉挛，但很少有报道将它们与使用摇头丸联系起来。我们报告一例27岁、此前健康的男性病例，该患者在使用摇头丸几天后出现胸骨后压榨性胸痛和广泛ST段抬高，尽管肌钙蛋白正常。他的表现随后冠状动脉造影正常，这与一次冠状动脉痉挛发作最为相符。服用MDMA促成了这一表现似乎是合理的。MDMA可通过增加血清素、多巴胺和去甲肾上腺素水平导致心血管问题，这可能会引起冠状动脉痉挛等症状。虽然将MDMA与急性冠状动脉综合征联系起来的确凿证据有限，但已报告有短暂性冠状动脉痉挛和血栓形成的病例，这表明需要对此类情况进行及时评估和处理。
