# Ecstasy-Induced Acute Myocardial Infarction Unraveled by Multimodality Imaging

## TL;DR

A 36-year-old man experienced a heart attack after using ecstasy, and multimodal imaging helped identify and monitor the condition.

## Contribution

The paper presents a novel case linking ecstasy use to acute myocardial infarction, supported by multimodality imaging insights.

## Key findings

- Multimodal imaging revealed an anteroseptal myocardial infarction with red thrombus in the LAD artery.
- Eptifibatide treatment led to reduced thrombus burden and improved cardiac function.
- CMR showed a small infarct with edema and a small apical clot, with significant clinical improvement.

## Abstract

A case of a 36-year-old male with no known comorbidities presented because of chest discomfort after using ecstasy and was noted to have an evolving anteroseptal myocardial infarction (MI). Left heart catheterization showed mild obstructive coronary disease with red thrombus in the proximal left anterior descending (LAD) artery seen on optical coherence tomography (OCT) and with note of improvement and decrease in thrombus burden on repeat coronary angiogram the next day after starting the patient on eptifibatide. Echocardiogram revealed mildly reduced systolic function with an apical akinesis. Cardiac magnetic resonance imaging (CMR) showed a small-sized infarct involving the apical inferior, apical lateral, and basal septum, with myocardial edema at the apex and septum, and a note of a small apical clot. He improved significantly during his course and was maintained on ticagrelor, apixaban, and atorvastatin.