Areca Nut Chewing Complicated with Non-Obstructive and Obstructive ST Elevation Myocardial Infarction.
Areca nut chewing is one of the most prevalent substance abuse habits in the world, and it is associated with the risk of a variety of medical challenges including hypertension, arrhythmia, and coronary artery disease (CAD). However, ST elevation myocardial infarction (STEMI) is an extremely rare complication of areca nut chewing. Herein we report two cases where patients suffered from STEMI after areca nut chewing. The first case involved a patient with non-obstructive CAD and non-sustained ventricular tachycardia during hospitalization. The second case revealed left circumflex artery total occlusion, and primary percutaneous coronary intervention was performed. Initially, the levels of arecoline and arecaidine plasma were checked in these two cases after admission. Although both cases revealed increased levels, the second case showed substantially higher values than the first case. In general, these two cases remind physicians that areca nut chewing may cause myocardial injury with different severity, although STEMI with true coronary obstruction remains an extremely rare but possible complication after areca nut chewing.


BACKGROUND
Areca nut chewing; Coronary obstruction; ST elevation myocardial infarction.
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University;
Ying-Chih
YC
Chen
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University; ; Department of Internal Medicine, Faculty of Medicine;
Hsiang-Chun
HC
Lee
Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Hei-Hwa
HH
Lee
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University; ; Department of Internal Medicine, Faculty of Medicine;
Ho-Ming
HM
Su
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University; ; Department of Internal Medicine, Faculty of Medicine;
Tsung-Hsien
TH
Lin
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University; ; Department of Internal Medicine, Faculty of Medicine; ; Graduate Institute of Medicine, School of Medicine, Kaohsiung Medical University;
Po-Chao
PC
Hsu