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Case Reports
. 2006 Mar 1;22(3):254-6.
doi: 10.1016/s0828-282x(06)70906-0.

Myocardial infarction associated with pseudoephedrine use and acute streptococcal infection in a boy with normal coronary arteries

Ismail Biyik  1 , Oktay Ergene
Affiliations
Case Reports

Myocardial infarction associated with pseudoephedrine use and acute streptococcal infection in a boy with normal coronary arteries

Ismail Biyik et al. Can J Cardiol. .

Abstract
in English, French

A 16-year-old boy presented to the emergency department with chest pain. He had no history of other health problems and did not smoke. Acute myocardial infarction (AMI) in an adolescent boy with normal coronary arteries, associated with pseudoephedrine use and acute streptococcal infection, is reported. The diagnosis of AMI was based on typical electrocardiographic signs, enzyme changes and echocardiographic evaluation. Coronary vasospasm associated with pseudoephedrine use, endothelial dysfunction and prothrombotic state caused by acute streptococcal infection may be the mechanisms responsible for AMI in this case. The possibility of AMI should be considered even in very young adolescents that have acute streptococcal pharyngeal infection, and it is important to obtain a complete history of the drugs used.

Un garçon de 16 ans est arrivé au département d’urgence avec des douleurs thoraciques. Il n’avait pas d’antécédents de problèmes de santé et ne fumait pas. Est déclaré un infarctus aigu du myocarde (IAM) chez un adolescent ayant des artères coronaires normales, associé à l’usage de pseudoéphédrine et à une infection à streptocoque aiguë. Le diagnostic d’IAM se fondait sur des signes électrocardiographiques classiques, des modifications enzymatiques et une évaluation échocardiographique. Un vasospasme coronaire relié à l’usage de pseudoéphédrine, à une dysfonction endothéliale et à un état prothrombotique causé par une infection à streptocoque aiguë pourrait être le mécanisme responsable de cet IAM. La possibilité d’IAM devrait être envisagée chez les adolescents atteints d’une infection streptococcique aiguë du pharynx, même s’ils sont très jeunes, et il est important d’obtenir les antécédents complets des médicaments utilisés.

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Figures

Figure 1)
Figure 1)
Electrocardiogram on admission
Figure 2)
Figure 2)
Angiographically normal coronary arteries
Figure 3)
Figure 3)
Electrocardiogram 30 days after myocardial infarction
See this image and copyright information in PMC

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