SESSION TITLE: Cardiovascular Student/Resident Case Report Posters I
SESSION TYPE: Medical Student/Resident Case Report
PRESENTED ON: Tuesday, October 29, 2013 at 01:30 PM - 02:30 PM
INTRODUCTION: Coronary artery disease is the most common cause of death in the United States. Dietary supplements to reduce weight have been increasingly used in the United States. We present an unusual case of coronary and pulmonary thrombosis in a young male with no coronary risk factors who was using dietary supplement.
CASE PRESENTATION: A 27 year old healthy college student presented to emergency department with sudden onset of chest pain at rest. He was found to have ST elevation in anterior lead. He underwent urgent percutaneous coronary intervention for completely occluded left anterior descending artery. He was found to have unusually high thrombus burden without any evidence of plaque formation. He remained tachypnic and tachycardic after successful coronary intervention. A computed tomography angiography of thorax revealed pulmonary embolism. He had no history of smoking, hypertension, hyperlipidemia, diabetes, family history of early coronary artery disease. His laboratory work up showed normal lipid panel (HDL 78, LDL 65, Total cholesterol 151, Triglyceride 65), Hemoglobin A1c (4.6), Urine drug screen was negative for substance of abuse. Full work up for hypercoagulability was negative. The echocardiography with bubble study showed no evidence of patent foramen ovale. He was treated with dual antiplatelet agent and warfarin. He was using dietary supplement named “Oxyelite Pro” for 6 weeks prior to the event with 10 pound weight loss.
DISCUSSION: Dietary supplements are currently a multi-billion dollar industry due to consumer demand for natural products to improve health. They are available over the counter, and advertised widely through many streams of media. Due to their accessibility, inexpensiveness and natural characteristic, dietary supplements are utilized widely. There are few case reports of myocardial infarction in subjects using dietary supplement containing ephedra, yohimbine and synerphine. Some of the ingredients of “Oxyelite Pro” cause vasoconstriction which might have contributed towards the event.
CONCLUSIONS: Although there have been no published case reports on myocardial infarction or pulmonary embolism in subjects taking Oxyelite Pro or dietary supplements containing ingredients of Oxyelite Pro, our patient neither had conventional and conditional risk factors for early myocardial infarction nor had risk factors for pulmonary embolism. Our patient’s coronary and pulmonary thrombosis could be related to the use of dietary supplement. Further research needs to be conducted to make an association and the FDA should regulate dietary supplements.
Reference #1: Rosamond W, Flegal K, Furie K, et al. Heart disease and stroke statistics. Circulation. 2008;117(4):e25-146.
Reference #2: Lloyd-Jones D, Adams RJ, Brown TM, et al. Executive summary: heart disease and stroke statistics. Circulation.2010;121(7):948-54.
DISCLOSURE: The following authors have nothing to disclose: Jhapat Thapa, Subhas Sitaula, Astha Ramaiya
No Product/Research Disclosure Information