Cocaine-induced coronary thrombosis and acute myocardial infarction

A 26-year-old man was admitted to our hemodynamic laboratory because of an anterior AMI and post myocardial infarction angina. He is an active smoker (10 cigarettes/day) and consumes inhaled cocaine during weekends (the last consumption of cocaine was 1 week ago). No others risk factors were recorded. Initial electrocardiogram shows sinus rhythm and anterior QS complex (V1–V3) with anterolateral ST segment elevation (V1–V5, D1 and aVL). Creatine-kinase isoenzyme MB and Troponin I were elevated at arrival. Upon admission, the patient was normotensive but with signs of pulmonary congestion. Ventriculography showed anterolateral and apical hypokinesia with an ejection fraction of 21%. Coronari…