Key result
Intratracheal cocaine triggers coronary artery spasm and anterior MI during bronchoscopy in a 73-year-old man.
Why the study?
Cocaine induced myocardial infarction following intratracheal injections during fibreoptic bronchoscopy is an unusual and underreported complication.
Case Report (n=1)
Intratracheal cocaine used for topical anesthesia during bronchoscopy can induce coronary artery spasm leading to myocardial infarction.
Highlights severe ischemic risks of topical cocaine anesthesia during routine airway procedures; leaves open whether alternative local anest.
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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Serge Osula (2003) conducted a case report in Myocardial infarction (n=1). Intratracheal cocaine was evaluated on Myocardial infarction and coronary artery spasm. Intratracheal injection of 5 ml 2.5% cocaine solution during fibreoptic bronchoscopy induced coronary artery spasm and an evolving anterior myocardial infarction in a 73-year-old man.
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