Amphetamine-related myocardial infarction in a 42-year old man

Myocardial infarction is an infrequent condition in young adults. In most cases, it occurs due to causes other than atherosclerosis of the coronary arteries, including blood hypercoagulability, congenital anomalies of the coronary arteries, their inflammation or spasm induced by amphetamine or cocai...

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Main Authors: Anna Smędra, Szymon Szustowski, Jarosław Berent
Format: Article
Language:English
Published: Polish Society of Forensic Medicine and Criminology (PTMSiK) 2016-03-01
Series:Archives of Forensic Medicine and Criminology
Subjects:
Online Access:http://www.termedia.pl/Amphetamine-related-myocardial-infarction-in-a-42-year-old-man,82,27027,1,1.html
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author Anna Smędra
Szymon Szustowski
Jarosław Berent
author_facet Anna Smędra
Szymon Szustowski
Jarosław Berent
author_sort Anna Smędra
collection DOAJ
description Myocardial infarction is an infrequent condition in young adults. In most cases, it occurs due to causes other than atherosclerosis of the coronary arteries, including blood hypercoagulability, congenital anomalies of the coronary arteries, their inflammation or spasm induced by amphetamine or cocaine use. Amphetamine and its derivatives, via increasing the levels of epinephrine, serotonin and dopamine in the central nervous system, exert their effect also on the cardiovascular system, causing coronary spasm, enhancing platelet aggregation and inducing tachyarrhythmias. The paper presents a case of a 42-year-old man admitted to the emergency department because of emaciation and dehydration. The man was conscious, without contact, with a significant elevation of body temperature and tachycardia. On the basis of examinations, a fresh infarction of the anterolateral wall of the heart was diagnosed and the patient was transferred to a cardiac intensive care unit. There, laboratory tests revealed significantly elevated markers of myocardial necrosis and the presence of amphetamine in blood and urine. In spite of the institution of treatment the patient developed cardiorespiratory arrest. Advanced resuscitation procedures were undertaken, however, they proved unsuccessful. The presence of an infarction focus was confirmed in autopsy. Toxicological analysis of the blood for the presence of alcohol-like substances detected amphetamine at a concentration of 269.5 ng/ml. After examining the complete body of evidence it was established that the patient had died of acute cardiorespiratory failure secondary to an extensive fresh myocardial infarction. As indicated by the accumulated data, the most probable cause of myocardial infarction was amphetamine poisoning.
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spelling doaj.art-c1e5a4151168488ea00b2155b48130a52023-08-02T00:42:35ZengPolish Society of Forensic Medicine and Criminology (PTMSiK)Archives of Forensic Medicine and Criminology0324-82671689-17162016-03-0165317318110.5114/amsik.2015.5816227027Amphetamine-related myocardial infarction in a 42-year old manAnna SmędraSzymon SzustowskiJarosław BerentMyocardial infarction is an infrequent condition in young adults. In most cases, it occurs due to causes other than atherosclerosis of the coronary arteries, including blood hypercoagulability, congenital anomalies of the coronary arteries, their inflammation or spasm induced by amphetamine or cocaine use. Amphetamine and its derivatives, via increasing the levels of epinephrine, serotonin and dopamine in the central nervous system, exert their effect also on the cardiovascular system, causing coronary spasm, enhancing platelet aggregation and inducing tachyarrhythmias. The paper presents a case of a 42-year-old man admitted to the emergency department because of emaciation and dehydration. The man was conscious, without contact, with a significant elevation of body temperature and tachycardia. On the basis of examinations, a fresh infarction of the anterolateral wall of the heart was diagnosed and the patient was transferred to a cardiac intensive care unit. There, laboratory tests revealed significantly elevated markers of myocardial necrosis and the presence of amphetamine in blood and urine. In spite of the institution of treatment the patient developed cardiorespiratory arrest. Advanced resuscitation procedures were undertaken, however, they proved unsuccessful. The presence of an infarction focus was confirmed in autopsy. Toxicological analysis of the blood for the presence of alcohol-like substances detected amphetamine at a concentration of 269.5 ng/ml. After examining the complete body of evidence it was established that the patient had died of acute cardiorespiratory failure secondary to an extensive fresh myocardial infarction. As indicated by the accumulated data, the most probable cause of myocardial infarction was amphetamine poisoning.http://www.termedia.pl/Amphetamine-related-myocardial-infarction-in-a-42-year-old-man,82,27027,1,1.htmlmyocardial infarction amphetamine toxicological investigations
spellingShingle Anna Smędra
Szymon Szustowski
Jarosław Berent
Amphetamine-related myocardial infarction in a 42-year old man
Archives of Forensic Medicine and Criminology
myocardial infarction
amphetamine
toxicological investigations
title Amphetamine-related myocardial infarction in a 42-year old man
title_full Amphetamine-related myocardial infarction in a 42-year old man
title_fullStr Amphetamine-related myocardial infarction in a 42-year old man
title_full_unstemmed Amphetamine-related myocardial infarction in a 42-year old man
title_short Amphetamine-related myocardial infarction in a 42-year old man
title_sort amphetamine related myocardial infarction in a 42 year old man
topic myocardial infarction
amphetamine
toxicological investigations
url http://www.termedia.pl/Amphetamine-related-myocardial-infarction-in-a-42-year-old-man,82,27027,1,1.html
work_keys_str_mv AT annasmedra amphetaminerelatedmyocardialinfarctionina42yearoldman
AT szymonszustowski amphetaminerelatedmyocardialinfarctionina42yearoldman
AT jarosławberent amphetaminerelatedmyocardialinfarctionina42yearoldman