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Case Report
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| Acute coronary syndrome associated with phencyclidine use | ||||||
| Hakeem Ayinde1, Robert Solomon2, Maria-Elise Sanchez2, James Diggs3 Prafulla Mehrotra4 | ||||||
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1Resident Physician, Department of Medicine, Howard University Hospital, Washington, DC.
2Medical Student, Howard University College of Medicine, Washington DC. 3Associate Professor, Division of Cardiology, Department of Internal Medicine, Howard University Hospital, Washington DC. 4Professor and Interim Chair, Division of Cardiology, Department of Internal Medicine, Howard University Hospital, Washington DC. | ||||||
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| How to cite this article |
| Ayinde H, Solomon R, Sanchez ME, Diggs J, Mehrotra P. Acute coronary syndrome associated with phencyclidine use. Int J Case Rep Images 2015;6(10):632–635. |
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Abstract
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Introduction:
Many studies have documented the deleterious effects of psychoactive substances like cocaine and amphetamines on the coronary vasculature. However, the impact of phencyclidine (PCP) on the arteries of the heart has largely gone unrecorded.
Case Report: We report a case of a 41-year-old female presented to our hospital with chest heaviness, shortness of breath, and nausea, which started at rest and lasted about 30 minutes. Her symptoms resolved on arrival to the emergency room. Electrocardiogram showed transient T wave inversions in V2 and V3 leads, and troponins peaked at 1.01 ng/ml 6 hours after arrival. She received standard therapy for non-ST elevation myocardial infarction. An urgent cardiac catheterization revealed severe vasospasm in 3 cm length of the proximal left anterior descending artery, and milder vasospasm in the mid-portion of the artery; spasm resolved after multiple doses of intracoronary nitroglycerin. We excluded the presence of common precipitants of coronary vasospasm. However, the patient admitted to phencyclidine use about two hours prior to the onset of symptoms, and a urine toxicology screen was positive only for the drug. Given the strong temporal relationship of symptoms to PCP use and absence of common precipitants of coronary vasospasm, we concluded that her coronary spasms were induced by PCP. Conclusion: We describe a case of acute coronary syndrome in a low risk patient thought to be induced by PCP. Our case illustrates the need for physicians to be aware of PCP ingestion as a possible cause of coronary artery spasm when presented with a young adult patient suffering from acute coronary syndrome. | |
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Keywords:
Chest pain, Coronary vasospasm, Phencyclidine
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Author Contributions
Hakeem Ayinde – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Robert Solomon – Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Maria-Elise Sanchez – Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published James Diggs – Acquisition of data, Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published Prafulla Mehrotra – Substantial contributions to conception and design, Analysis and interpretation of data, Revising it critically for important intellectual content, 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
© 2015 Hakeem Ayinde et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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