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Published in: Journal of Cardiothoracic Surgery 1/2010

Open Access 01-12-2010 | Case report

Acute left main coronary artery thrombosis due to cocaine use

Authors: Efstratios Apostolakis, Grigorios Tsigkas, Nikolaos G Baikoussis, Ioanna Koniari, Dimitrios Alexopoulos

Published in: Journal of Cardiothoracic Surgery | Issue 1/2010

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Abstract

It is common knowledge that cocaine has been linked to the development of various acute and chronic cardiovascular complications including acute coronary syndromes. We present a young, male patient, drug abuser who underwent CABG due to anterolateral myocardial infarction. Our presentation is one of the very rare cases reported in literature regarding acute thrombosis of left main coronary artery related to cocaine use, in a patient with normal coronary arteries, successfully operated. Drug-abusers seem to have increased mortality and morbidity after surgery and high possibility for stent thrombosis after percoutaneous coronary interventions, because of their usually terrible medical compliance and coexistent several problems of general health. There are no specific guidelines about treatment of thrombus formation in coronary arteries, as a consequence of cocaine use. So, any decision making concerning the final treatment of these patient is a unique and individualized approach. We strongly recommend that all these patients should be treated surgically, especially patients with thrombus into the left main artery.
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Literature
1.
go back to reference Coleman DL, Ross TF, Naughton JL: Myocardial ischemia and related to recreational cocaine use. West J Med. 1982, 136: 444-6.PubMedPubMedCentral Coleman DL, Ross TF, Naughton JL: Myocardial ischemia and related to recreational cocaine use. West J Med. 1982, 136: 444-6.PubMedPubMedCentral
2.
go back to reference Mittleman MA, Mintzer D, Maclure M, Tofler GH, Sherwood JB, Muller JE: Triggering of myocardial infarction by cocaine. Circulation. 1999, 99: 2737-41.CrossRefPubMed Mittleman MA, Mintzer D, Maclure M, Tofler GH, Sherwood JB, Muller JE: Triggering of myocardial infarction by cocaine. Circulation. 1999, 99: 2737-41.CrossRefPubMed
3.
go back to reference Lange R, Hillis D: Cardiovascular complications of cocaine use. N Engl J Med. 2001, 345: 351-58. 10.1056/NEJM200108023450507.CrossRefPubMed Lange R, Hillis D: Cardiovascular complications of cocaine use. N Engl J Med. 2001, 345: 351-58. 10.1056/NEJM200108023450507.CrossRefPubMed
4.
go back to reference Kugelmass AD, Oda A, Monahan K, Cabral C, Ware JA: Activation of human platelets by cocaine. Circulation. 1993, 88: 876-83.CrossRefPubMed Kugelmass AD, Oda A, Monahan K, Cabral C, Ware JA: Activation of human platelets by cocaine. Circulation. 1993, 88: 876-83.CrossRefPubMed
5.
go back to reference Flores ED, Lange RA, Cigarroa RG, Hillis LD: Effect of cocaine on coronary artery dimensions in atherosclerotic coronary artery disease: enhanced vasoconstriction at sites of significant stenoses. J Am Coll Cardiol. 1990, 16: 74-9. 10.1016/0735-1097(90)90459-3.CrossRefPubMed Flores ED, Lange RA, Cigarroa RG, Hillis LD: Effect of cocaine on coronary artery dimensions in atherosclerotic coronary artery disease: enhanced vasoconstriction at sites of significant stenoses. J Am Coll Cardiol. 1990, 16: 74-9. 10.1016/0735-1097(90)90459-3.CrossRefPubMed
6.
go back to reference Wilbert-Lampen U, Seliger C, Zilker T, Arendt RM: Cocaine increases the endothelial release of immunoreactive endothelin and its concentrations in human plasma and urine: reversal by coincubation with sigmareceptor antagonists. Circulation. 1998, 98: 385-90.CrossRefPubMed Wilbert-Lampen U, Seliger C, Zilker T, Arendt RM: Cocaine increases the endothelial release of immunoreactive endothelin and its concentrations in human plasma and urine: reversal by coincubation with sigmareceptor antagonists. Circulation. 1998, 98: 385-90.CrossRefPubMed
7.
go back to reference Hollander JE, Hoffman RS, Burstein JL, Shih RD, Thode HC: Cocaine-associated myocardial infarction: mortality and complications. Arch Intern Med. 1995, 155: 1081-6. 10.1001/archinte.155.10.1081.CrossRefPubMed Hollander JE, Hoffman RS, Burstein JL, Shih RD, Thode HC: Cocaine-associated myocardial infarction: mortality and complications. Arch Intern Med. 1995, 155: 1081-6. 10.1001/archinte.155.10.1081.CrossRefPubMed
8.
go back to reference Joffe BD, Broderick TM, Leier CV: Cocaine-induced coronary artery dissection. N Engl J Med. 1994, 330: 510-511. 10.1056/NEJM199402173300719.CrossRef Joffe BD, Broderick TM, Leier CV: Cocaine-induced coronary artery dissection. N Engl J Med. 1994, 330: 510-511. 10.1056/NEJM199402173300719.CrossRef
9.
go back to reference Karlsson G, Rehman J, Kalaria V, Breall J: Increased incidence of stent thrombosis in patients with cocaine use. Cath Cardiovasc Interv. 2007, 69: 955-58. 10.1002/ccd.21151.CrossRef Karlsson G, Rehman J, Kalaria V, Breall J: Increased incidence of stent thrombosis in patients with cocaine use. Cath Cardiovasc Interv. 2007, 69: 955-58. 10.1002/ccd.21151.CrossRef
10.
go back to reference Singh S, Arora R, Khraisat A, Handa K, Bahekar A, Trivedi A, Khosla S: Increased incidence of in-stent thrombosis related to cocaine-use: case series and review of Literature. J Cardiovasc Pharmacol Theur. 2007, 12: 298-303. 10.1177/1074248407306671.CrossRef Singh S, Arora R, Khraisat A, Handa K, Bahekar A, Trivedi A, Khosla S: Increased incidence of in-stent thrombosis related to cocaine-use: case series and review of Literature. J Cardiovasc Pharmacol Theur. 2007, 12: 298-303. 10.1177/1074248407306671.CrossRef
Metadata
Title
Acute left main coronary artery thrombosis due to cocaine use
Authors
Efstratios Apostolakis
Grigorios Tsigkas
Nikolaos G Baikoussis
Ioanna Koniari
Dimitrios Alexopoulos
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Journal of Cardiothoracic Surgery / Issue 1/2010
Electronic ISSN: 1749-8090
DOI
https://doi.org/10.1186/1749-8090-5-65

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