دانلود رایگان مقاله انگلیسی موردی کمیاب کوکائین القا شده آنوریسم آئورت: یک رویداد تشریحی - هینداوی 2017

Cocaine use has been associated with cardiovascular complications such as coronary atherosclerosis, coronary artery spasm, cardiac arrhythmias, acute myocardial infarction, myocarditis, and dilated cardiomyopathies. Aortic dissection is a rare but lifethreatening complication of cocaine use. Cocaine and stimulant use can cause aortic aneurysm by increasing the aortic wall stress, and the most feared complications are dissection, rupture, and death. *ere are no clear guidelines about screening cocaine abusers with CT scan of the chest. We do not know if the number of years of cocaine use or the amount of cocaine use can be associated with higher incidence of aortic aneurysm or dissection. Cocaine-induced aortic aneurysm does not have any speci1c clinical feature. Common presentation is chest discomfort or chest pain. *is common presentation is bewildering enough for clinicians to think of more common causes of chest pain like myocardial infarction and myocarditis. *e sudden onset of severe, sharp, stabbing chest or back pain is suggestive of aortic dissection. Here, we present a young otherwise healthy patient with chronic cocaine use presenting with chest pain and found to have signi1cant size aortic aneurysm.

3. Discussion

This case illustrates that cocaine can be a predisposing factor for aortic aneurysm and/or dissection in otherwise healthy, young, and not genetically predisposed person [5]. Our patient had trilea4et aortic valve, negative family history, and no medial degeneration (previously designated cystic medial necrosis) in the pathology, thus making the congenital process less likely. *ere was no trauma or hypertension history. We did not think of doing CT at the initial presentation in this patient. ACC/AHA guideline does mention cocaine as a risk factor for thoracic aneurysm, but it does not have screening guidelines in cocaine abusers [6]. *e question is, is it worth doing CT chest in every cocaine abuser presenting with chest pain? No clear answer to this question exists, but there is a high suspicion for etiology, considering CT in appropriate patients is reasonable. Although cocaine is a rare cause of this life-threatening and rare diagnosis [3], astute suspicion will help prevent a fatal consequence [1, 7].