Caires G, Mesquita A, Castilho T, Brízida L, Morgado F, Bonhorst D, Queirós e Melo J, Gomes R S
Serviço de Cardiologia, Hospital de Santa Cruz, Carnaxide.
Rev Port Cardiol. 1996 Dec;15(12):885-91, 864.
In patients less than 40 years of age, acute myocardial infarction (AMI) has special clinical and pathophysiologic characteristics. Its prevalence varies between 5 and 10%. In such patients, AMI associated with chronic cocaine abuse has a non-negligible prevalence of 6%. The purpose of this report is to describe the case of a 24-year old male patient with smoking habits and chronic abuse of cocaine and hallucinogenic drugs. This patient developed clinical, enzymatic and electrocardiographic criteria of anterior AMI, two hours after the ingestion of an LSD-like hallucinogenic drug. The coronary angiography revealed a critical stenosis of the medium segment of the left anterior descendent artery, and a pre-stenotic aneurysmatic dilatation. In order to determine the etiology of the aneurysm, various laboratory and histologic tests were performed. The results of these were normal. We review the pathophysiology, clinical manifestations and prognosis of cocaine-associated AMI.
在40岁以下的患者中,急性心肌梗死(AMI)具有特殊的临床和病理生理特征。其患病率在5%至10%之间。在此类患者中,与长期滥用可卡因相关的AMI患病率为6%,不可忽视。本报告的目的是描述一名24岁男性患者的病例,该患者有吸烟习惯,长期滥用可卡因和致幻药物。该患者在摄入一种类似麦角酸二乙酰胺(LSD)的致幻药物两小时后,出现了前壁AMI的临床、酶学和心电图标准。冠状动脉造影显示左前降支动脉中段严重狭窄,狭窄前有动脉瘤样扩张。为了确定动脉瘤的病因,进行了各种实验室和组织学检查。检查结果均正常。我们回顾了可卡因相关性AMI的病理生理学、临床表现和预后。