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Case Report
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| Amphetamine abuse and acute thrombosis of left circumflex coronary artery | ||||||
| Eyad Khattab1, Asaad Shujaa2 | ||||||
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1MD, MPH, Demonstrator, Department of Emergency Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia.
2Resident, Department of Internal Medicine, University of Toledo Medical Center, Toledo, Ohio, United States of America. | ||||||
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| How to cite this article: |
| Khattab E, Shujaa A. Amphetamine abuse and acute thrombosis of left circumflex coronary artery. International Journal of Case Reports and Images 2013;4(12):698–701. |
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Abstract
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Introduction:
Currently, amphetamine abuse is a widespread problem. While the use of recreational drugs is more common in young populations, drug abuse within elderly populations is increasing, though largely unrecognized. The exact nature and dose of recreational drugs are difficult to identify when a patient presents requiring urgent care, notably amphetamine-induced acute coronary syndrome (ACS).
Case Report: A 54-year-old male smoker presented with classical anginal chest pain after using amphetamines. Electrocardiography (ECG) showed T-wave inversion in leads I, aVL, and V4-V6. Laboratory data revealed total creatine kinase (CK) level 1759 IU/L, CK-MB 87 IU/L, and a troponin-I of 13.38 ng/mL. A diagnosis of non-ST elevation myocardial infarction (NSTEMI) was made. The emergency room physician commenced the NSTEMI protocol, but the patient experienced worsening chest pain unresponsive to nitrates or morphine, with no change in the ECG pattern. The cardiologist decided to proceed with percutaneous coronary intervention. Coronary angiography revealed 100% stenosis in the proximal portion of the left circumflex artery, with a large clot burden. The artery was stented with excellent results. Later testing showed a positive urine toxicology screen for amphetamines. Conclusion: Regardless of the age or gender of the patient, asking questions about stimulant drugs use is crucial with anginal chest pain presentation. Drug abuse is not only for young males but older males and females are also susceptible, and can have unique responses to amphetamine abuse. In this case, amphetamine abuse caused myocardial ischemia due to blood clot formation. | |
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Keywords:
Amphetamine, Left Circumflex
Coronary Artery, Non-ST elevation myocardial infraction (NSTEMI)
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Author Contributions
Eyad Khattab – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published Asaad Shujaa – Conception and design, Acquisition of data, Drafting the article, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© Eyad Khattab et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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