RESUMO
Cannabis is the most widely used illicit drug in the world. It is generally considered to be a drug with low toxicity. Nevertheless, there are several case reports of myocardial infarction following cannabis use in otherwise low-risk individuals. We report the first case of a cannabis user presenting with acute coronary syndrome related to multivessel coronary artery dissection.
Assuntos
Reestenose Coronária/terapia , Trombose Coronária/complicações , Oclusão de Enxerto Vascular/terapia , Stents , Angioplastia Coronária com Balão , Reestenose Coronária/etiologia , Trombose Coronária/terapia , Feminino , Oclusão de Enxerto Vascular/etiologia , Humanos , Anastomose de Artéria Torácica Interna-Coronária , Pessoa de Meia-Idade , Grau de Desobstrução VascularAssuntos
Aneurisma Coronário/diagnóstico , 4-Hidroxicumarinas/administração & dosagem , Anticoagulantes/administração & dosagem , Aspirina/administração & dosagem , Aneurisma Coronário/tratamento farmacológico , Angiografia Coronária , Vasos Coronários/patologia , Feminino , Seguimentos , Humanos , Indenos/administração & dosagem , Pessoa de Meia-Idade , Vitamina K/administração & dosagem , Vitamina K/antagonistas & inibidoresRESUMO
Infective endocarditis is an uncommon but potentially lethal complication of permanent cardiac pacing. Infection is mainly caused by local contamination during the implantation procedure. The most frequently detected causative microorganisms were staphylococci. The clinical presentation is often atypical causing prolonged diagnostic delay. Bacteriological data and visualisation of neostructures consistent with vegetations on transoesophageal echocardiography, strongly suggest pacemaker lead infection. Management is based on a combined approach using both prolonged antibiotic treatment and early complete device explantation. Percutaneous techniques are currently the method of choice for lead extraction but it is not without possible complications. Antibiotic prophylaxis in order to reduce infection risk related to pacemaker implantation is widely recommended.