| High serum tryptase value in massive acute myocardial infarction with ventricular arrhythmia exortion in a cocaine abuser. | |
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MedLine Citation:
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PMID: 19505405 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A 38-year-old cocaine abuser was admitted to the Emergency Department with a one hour history of precordial chest pain associated with shortness of breath and extreme discomfort. On admission his blood pressure was 90/60 mmHg, the resting 12-lead ECG showed ventricular tachycardia at about 300 beats per minute, and oxygen saturation was 86 percent in room air. After electrical cardioversion, the 12-lead ECG revealed sinusal rhythm and a significative ST segment elevation in leads I, aVL and V1-V6, that was about 0.5 mV in leads I and aVL and more than 1 mV in leads V2, V3 and V4. Laboratory determinations showed elevated creatine-chinase MB (CK-MB) and troponin I. An emergency coronary angiogram was normal. Cocaine use is a major cause of acute myocardial infarction in patients with normal epicardial coronary arteries but the exact mechanism still remains unclear. We hypothesize a non-IgE mediated mast-cell activation, with a direct action played by cocaine, and consequent massive expression of several factors effecting the microcirculatory system, including pro-inflammatory cytokines and chemokines. Our hypothesis is supported by an elevated serum tryptase levels in the patient. |
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Authors:
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C Caroselli; P Perfetti; G Bruno |
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Publication Detail:
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Type: Case Reports; Letter |
Journal Detail:
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Title: International journal of immunopathology and pharmacology Volume: 22 ISSN: 0394-6320 ISO Abbreviation: Int J Immunopathol Pharmacol Publication Date: 2009 Apr-Jun |
Date Detail:
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Created Date: 2009-06-09 Completed Date: 2009-07-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8911335 Medline TA: Int J Immunopathol Pharmacol Country: Italy |
Other Details:
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Languages: eng Pagination: 525-9 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Biological Markers / blood Cocaine-Related Disorders / complications*, enzymology, immunology Creatine Kinase, MB Form / blood Electrocardiography Humans Male Mast Cells / enzymology* Myocardial Infarction / enzymology, etiology*, immunology Tachycardia, Ventricular / enzymology, etiology*, immunology Troponin I / blood Tryptases / blood* Up-Regulation |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Troponin I; EC 2.7.3.2/Creatine Kinase, MB Form; EC 3.4.21.59/Tryptases |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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