Simultaneous Thrombosis of the Left Anterior Descending Artery and the Right Coronary Artery in a 34-Year-Old Crystal Methamphetamine Abuser

This case report underscores that crystal methamphetamine abuse is an important cause of multivessel coronary thrombosis and raises doubts about the therapeutic options. The patient was a 34-year-old smoker and crystal methamphetamine abuser with no significant medical history, who presented with retrosternal chest pain associated with cold sweats. Twelve-lead electrocardiogram revealed diffuse ST-segment elevation in I, II, AVL, AVF, and V 2-6 leads. He underwent urgent coronary angiography and it showed Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow in coronary arteries and presence of a thrombus in the left anterior descending artery (LAD) and the right coronary artery (RCA). The patient underwent medical therapy with antiplatelet agents and anticoagulants. Repeat coronary angiography after three months of dual therapy with warfarin and aspirin did not show any thrombus or any significant lesion in the RCA and the LAD having TIMI grade 3 flow.

Diffuse pulmonary hemorrhage after fibrinolytic therapy for acute myocardial infarction in a cocaine abuser patient

We report a 45-year-old man with antroseptal myocardial infarction who developed bilateral basal alveolar infiltrates after initiating the fibrinolytic therapy. Although thrombolytic therapy with streptokinase is generally used in the course of acute myocardial infarction and has diminished morbidity and mortality, pulmonary hemorrhage is an uncommon, but a potentially life-threatening complication that should be regarded as one of the differential diagnoses of pulmonary infiltrates or dropping hemoglobin with no apparent bleeding site

Acute myocardial infarction in a 35-year-old man with coronary artery aneurysm most probably caused by Kawasaki disease

We present a 35-year-old man with history of Kawasaki disease who referred with myocardial infarction, and angiography, revealing aneurysm of left main and left anterior descending coronary arteries. The patient underwent percutaneous coronary intervention and thrombectomy and was discharged after 6 d. Coronary artery sequels of Kawasaki disease should be considered as one of the underlying causes of acute myocardial infarction in young adults.

[TGF- beta 1 gene expression in skin lesions and correlation with pruritus in mustard gas exposed victims]

As a blistering agent, mustard gas causes a variety of disorders in different body organs, including the skin, such as altrations in DNA and clinical manifestations like pruritus. TGF- beta 1 molecule is a cytokine with anti-cell growth and inflammation suppression effects in skin inflammation. The aim of this study was to determine TGF- beta 1 gene exprtession in victims exposed to mustard gas and the correlation with the severity of their pruritus. 17 victims exposed to mustard gas, 17 patients with chronic contact dermatitis and 10 healthy individuals were included in the study. The assessment of TGF- beta 1 expression in their skin samples was conducted by semi-quantitative RT-PCR followed by immunohistochemistry and classification of patients was done by pruritus severity scoring system [0-3]. There was a significant decrease in TGF- beta 1 gene expression in mustard gas exposed victims comparing to chronic contact dermatitis group and the control group [P<0.05]. In addition, in the absence of TGF- beta 1 expression, the severity of pruritus in the patient group significantly increased [P<0.05]. TGF- beta 1 has a significant role in chronic inflammatory skin lesions caused by mustard gas