Abstract
Introduction: Many studies have documented the deleterious effects of psychoactive substances like cocaine and amphetamines on the coronary vasculature. However, the impact of phencyclidine (PcP) on the arteries of the heart has largely gone unrecorded. case report: We report a case of a 41-year-old female presented to our hospital with chest heaviness, shortness of breath, and nausea, which started at rest and lasted about 30 minutes. Her symptoms resolved on arrival to the emergency room. Electrocardiogram showed transient t wave inversions in V2 and V3 leads, and troponins peaked at 1.01 ng/ml 6 hours after arrival. she received standard therapy for non-st elevation myocardial infarction. An urgent cardiac catheterization revealed severe vasospasm in 3 cm length of the proximal left anterior descending artery, and milder vasospasm in the mid-portion of the artery; spasm resolved after multiple doses of intracoronary nitroglycerin.
Highlights
INTRODUCTIONPhencyclidine (PCP), a synthetic compound originally intended to be used as an anesthetic drug, has been abused throughout the United States for several decades
Many studies have documented the deleterious effects of psychoactive substances like cocaine and amphetamines on the coronary vasculature
Our case illustrates the need for physicians to be aware of PCP ingestion as a possible cause of coronary artery spasm when presented with a young adult patient suffering from acute coronary syndrome
Summary
Phencyclidine (PCP), a synthetic compound originally intended to be used as an anesthetic drug, has been abused throughout the United States for several decades. A 41-year-old African American woman presented to the emergency department complaining of chest heaviness, palpitations, shortness of breath, and nausea at rest, which lasted about 30 minutes. She had two similar episodes in the previous month, and these resolved without therapy. Laboratory studies revealed rising troponin levels that peaked at 1.01 ng/ml 6 hours after arrival. She was diagnosed with nonST elevation MI and given standard therapy of aspirin, clopidogrel, and enoxaparin, and she was subsequently prepared for urgent coronary angiography. The patient was discharged on sublingual nitroglycerin as needed, and advised to avoid PCP and other drugs of abuse in the future
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