SYNTHETIC CANNABINOID ABUSE RESULTING IN ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION REQUIRING PERCUTANEOUS CORONARY INTERVENTION
SYNTHETIC CANNABINOID ABUSE RESULTING IN ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION REQUIRING PERCUTANEOUS CORONARY INTERVENTION
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DOI：
10.1016/j.jemermed.2016.09.023
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发表时间：
2017-04-01
影响因子：
1.5
通讯作者：
Banka, Sahil S.
中科院分区：
文献类型：
--
作者：
Hamilton, Richard J.;Keyfes, Vadim;Banka, Sahil S.
背景：合成大麻素(SC)是一种娱乐特制药物，旨在模仿三角洲-9-四氢大麻酚，同时秘密规避美国药品监督管理局的分类。病例报告：一名50岁黑人男性在抱怨与吸烟有关的胸痛后，因精神状态改变而被紧急医疗服务中心(EMS)运送到急诊科。EMS发现这名患者拿着一个空的锡箔盒，上面写着‘’史酷比·斯奈克斯限量版蓝莓杂烩‘’。患者昏昏欲睡，但在受到刺激时变得焦躁不安，并抱怨胸痛。生命体征为血压87/52毫米汞柱，脉搏52次/分钟。心电图显示下壁心肌梗死。冠状动脉造影术发现了一支闭塞的边缘第二支，通过药物洗脱支架成功打开。病人平安无事地康复了。尿液药物筛查结果为可卡因阴性，烟熏物质的气相色谱/质谱仪检测确定PB-22和AMB-FUBINACA为有效成分。急诊医生为什么应该意识到这一点？：急诊医生和心脏病专家需要意识到，合成大麻素对内源性大麻系统的作用机制可能会导致急性ST段抬高心肌梗死，需要经皮冠状动脉介入治疗。(C)2016 Elsevier Inc.保留所有权利。
Background: Synthetic cannabinoids (SC) are recreational designer drugs intended to mimic delta-9-tetrahydrocannabinol while surreptitiously circumventing classification by the Drug Enforcement Administration. Case Report: A 50-year-old black male arrived in the Emergency Department transported by Emergency Medical Services (EMS) for altered mental status after complaining of chest pain associated with smoking SCs. EMS found the patient with an empty foil pack labeled ``Scooby Snax Limited Edition Blueberry Potpourri.'' The patient was somnolent, but became agitated when stimulated and complained of chest pain. Vital signs were blood pressure 87/52 mm Hg and pulse 52 beats/min. The electrocardiogram demonstrated an inferior wall myocardial infarction. Coronary angiography identified an occluded obtuse marginal second branch that was successfully opened with a drug-eluting stent. The patient recovered uneventfully. Urine drug screen was negative for cocaine, and gas chromatography/mass spectrometry testing of the smoked material identified PB-22 and AMB-FUBINACA as the active ingredients. Why Should an Emergency Physician Be Aware of This?: Emergency physicians and cardiologists need to be aware that the mechanism of action of synthetic cannabinoids on the endocannabinoid system may result in acute ST-segment elevation myocardial infarction requiring percutaneous coronary intervention. (C) 2016 Elsevier Inc. All rights reserved.