A case of acute myocardial infarction associated with amphetamine abuse / 대한내과학회지

ABSTRACT

Acute myocardial infarction is a rarely reported complication of amphetamine abuse. We report here on a case of a 39-year-old man who presented with cardiac enzyme patterns, a clinical history and an ECG that were all compatible with acute ST elevation myocardial infarction. This was probably the result from self administration of intravenous amphetamine. The initial coronary angiogram (CAG) showed total occlusion of the distal right coronary artery (RCA) with a large thrombus. Because the RCA was tortuous and removal of thrombus was thought not to be easy, he was treated with thrombolytic therapy and intravenous heparin followed by oral warfarin. The follow-up CAGs at 2 weeks and 10 months later showed almost complete resolution of the coronary abnormalities. In this case, the early coronary angiography was thought to be helpful to determine the relative contribution of thrombus and spasm that were associated with amphetamine abuse.