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Coronary Artery Rupture Associated With Amphetamine Abuse

Brennan, Kathleen MD; Shurmur, Scott MD; Elhendy, Abdou MD, PhD

Finalist, Fellowship/Residency Clinical Case Contest

We report a case of spontaneous coronary artery rupture associated with amphetamine abuse in a 31-year-old woman. The patient presented to the emergency department with sudden onset of central chest pain and a normal electrocardiogram. Cardiac enzymes were consistent with acute myocardial infarction. Drug screening was positive for amphetamines. Coronary angiography revealed an aneurysmal lesion with 99% occlusion of the proximal left circumflex coronary artery and extravasation of contrast material. Percutaneous coronary intervention was performed with stent placement. Antegrade flow was achieved without residual stenosis. This is the first reported case of coronary artery rupture related to amphetamine abuse.

From the Department of Internal Medicine, Section of Cardiology, University of Nebraska Medical Center, Omaha, Nebraska.

Reprints: Abdou Elhendy, MD, PhD, 982265 Nebraska Medical Center, Omaha, NE 68198-2265. E-mail: Aelhendy@unmc.edu

© 2004 Lippincott Williams & Wilkins, Inc.