Korean Circ J.  2015 Mar;45(2):158-160. 10.4070/kcj.2015.45.2.158.

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

• Khaheshi I
• Mahjoob MP
• Esmaeeli S
• Eslami V
• Haybar H

• KMID: 2297883
• DOI: http://doi.org/10.4070/kcj.2015.45.2.158

Abstract

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.

Keyword

Methamphetamine; Coronary thrombosis; Angiography

MeSH Terms

Adult*
Angiography
Anticoagulants
Arteries*
Aspirin
Chest Pain
Coronary Angiography
Coronary Thrombosis
Coronary Vessels*
Electrocardiography
Humans
Methamphetamine*
Myocardial Infarction
Platelet Aggregation Inhibitors
Sweat
Thrombosis*
Warfarin
Anticoagulants
Aspirin
Methamphetamine
Platelet Aggregation Inhibitors
Warfarin

Figure

• 

  Fig. 1 Twelve-lead electrocardiogram revealed ST-segment elevation in I, II, AVL, AVF, and V 2-6 leads.

• 

  Fig. 2 Initial cardiac catheterization showed a thrombus in the distal portion of the right coronary artery (arrow) just before bifurcation (A) just before bifurcation and a large thrombus in the proximal portion of the left anterior descending artery (arrow) (B) having Thrombolysis in Myocardial Infarction grade 3 flow

• 

  Fig. 3 Repeat cardiac catheterization after three months of dual therapy with warfarin and aspirin did not show any thrombus or any significant lesion in the right coronary artery (A) and the left anterior descending artery (B) having Thrombolysis in Myocardial Infarction grade 3 flow.

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