PMID- 26699935
OWN - NLM
STAT- MEDLINE
DCOM- 20161005
LR  - 20170103
IS  - 1444-2892 (Electronic)
IS  - 1443-9506 (Linking)
VI  - 25
IP  - 2
DP  - 2016 Feb
TI  - Complete Angiographic Resolution of Cocaine Induced Coronary Artery Dissection 
      within Eight Days without Coronary Stenting--A Case Report.
PG  - e24-8
LID - S1443-9506(15)01270-6 [pii]
LID - 10.1016/j.hlc.2015.06.829 [doi]
AB  - INTRODUCTION: Coronary dissection is a rarely reported complication of cocaine 
      use for which there are no specific guidelines on management despite the 
      widespread use of the drug. METHODS: We report a case of a 26-year-old otherwise 
      fit and healthy Caucasian male smoker who presented to our facility with an 
      infero-lateral ST elevation myocardial infarction (STEMI) following nasal 
      inhalation of 1 gram of cocaine. Coronary angiography showed a mid left anterior 
      descending (LAD) artery dissection with distal occlusive embolism and another 
      dissection of the distal right coronary artery (RCA) with embolism and occlusion 
      of the distal posterolateral branch. OUTCOME: Wiring of both vessels with a 
      High-Torque Floppy wire successfully re-established TIMI 3 flow with relief of 
      pain and resolution of his ST-segment elevation. Given the absence of any 
      flow-limiting lesions, stenting was avoided. He was subsequently put on a 
      combination of therapeutic dose enoxaparin, aspirin, ticagrelor, atorvastatin and 
      metoprolol. A repeat angiogram eight days later showed complete healing of the 
      dissections. CONCLUSION: This case shows that percutaneous management without 
      stenting coupled with aggressive anti-coagulation of cocaine induced coronary 
      dissection may result in an acceptable outcome especially in a young otherwise 
      fit and healthy patient.
CI  - Copyright (c) 2015 Australian and New Zealand Society of Cardiac and Thoracic 
      Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). 
      Published by Elsevier B.V. All rights reserved.
FAU - Wickremaarachchi, Chathupa
AU  - Wickremaarachchi C
AD  - Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, 
      Australia; Prince of Wales Hospital, Sydney, NSW, Australia.
FAU - Olinga, Jude
AU  - Olinga J
AD  - Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, 
      Australia.
FAU - Ooi, Sze-Yuan
AU  - Ooi SY
AD  - Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, 
      Australia.
FAU - Cranney, Gregory
AU  - Cranney G
AD  - Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, 
      Australia. Electronic address: greg.cranney@ehc.com.au.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20150715
PL  - Australia
TA  - Heart Lung Circ
JT  - Heart, lung & circulation
JID - 100963739
RN  - I5Y540LHVR (Cocaine)
RN  - Coronary Artery Dissection, Spontaneous
SB  - IM
MH  - Adult
MH  - Cocaine/*toxicity
MH  - *Coronary Angiography
MH  - *Coronary Vessel Anomalies/chemically induced/diagnostic imaging
MH  - Coronary Vessels/*diagnostic imaging
MH  - Humans
MH  - Male
MH  - *Myocardial Infarction/diagnostic imaging/surgery
MH  - *Stents
MH  - Time Factors
MH  - Vascular Diseases/chemically induced/*congenital/diagnostic imaging
OTO - NOTNLM
OT  - Angioplasty
OT  - Cocaine
OT  - Dissection
OT  - Myocardial infarction
EDAT- 2015/12/25 06:00
MHDA- 2016/10/07 06:00
CRDT- 2015/12/25 06:00
PHST- 2015/05/31 00:00 [received]
PHST- 2015/06/14 00:00 [accepted]
PHST- 2015/12/25 06:00 [entrez]
PHST- 2015/12/25 06:00 [pubmed]
PHST- 2016/10/07 06:00 [medline]
AID - S1443-9506(15)01270-6 [pii]
AID - 10.1016/j.hlc.2015.06.829 [doi]
PST - ppublish
SO  - Heart Lung Circ. 2016 Feb;25(2):e24-8. doi: 10.1016/j.hlc.2015.06.829. Epub 2015 
      Jul 15.