Intratracheal cocaine induced myocardial infarction: an unusual complication of fibreoptic bronchoscopy.

Osula, S; Stockton, P; Abdelaziz, M M; Walshaw, M J · Thorax · 2003

case_report · Level V

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Abstract

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.

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