Intratracheal cocaine induced myocardial infarction: an unusual complication of fibreoptic bronchoscopy.
A 73 year old man developed chest pains 5 minutes after fibreoptic bronchoscopy. The procedure had been performed without sedation following an intratracheal injection of 5 ml 2.5% cocaine solution and xylocaine spray to the pharynx for topical anaesthesia. A 12-lead electrocardiogram showed an evolving anterior myocardial infarction. Cardiac catheterisation revealed coronary artery spasm in the proximal left anterior descending artery at the site of non-significant plaque disease. The risk factors, mechanisms, and treatment of cocaine induced myocardial infarction following intratracheal injections are discussed.
Osula
S
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Cardiology Department, The Cardiothoracic Centre Liverpool, Liverpool, UK. mwalshaw@doctors.org.uk
Stockton
P
P
Abdelaziz
M M
MM
Walshaw
M J
MJ
D000368:Aged; D000779:Anesthetics, Local / Q000009:adverse effects*; D001999:Bronchoscopy / Q000009:adverse effects*; D003042:Cocaine / Q000009:adverse effects*; D004562:Electrocardiography; D005336:Fiber Optic Technology; D006801:Humans; D007278:Injections, Spinal; D008297:Male; D009203:Myocardial Infarction / Q000139:chemically induced*
D000779:Anesthetics, Local; D003042:Cocaine