Patients with illicit drug use may have deleterious acute and chronic cardiac effects. We present a case of a 42-year-old man, former alcohol and various illicit drugs user, who was admitted to the psychiatric unit for management of psychosis. Because of his previous drug and alcohol history, a cardiological evaluation was performed which revealed silent severe myocardial ischemia detected by myocardial perfusion imaging (MPI). The myocardial ischemia was attributed to coronary microvascular dysfunction, occurring several years after quitting the illicit drugs. This study highlights the potential myocardial ischemia that may occur in patients with previous alcohol and illicit drug use, and the role of MPI, a non-invasive test that can provide important information regarding the myocardial status of such patients, even without obvious cardiac symptoms or findings.

使用非法药物的患者可能会对心脏产生有害的急性和慢性影响。我们介绍了一名 42 岁男性的案例，他曾酗酒并吸食过各种非法药物，他被送往精神病科治疗精神病。由于他之前有药物和酒精史，因此进行了心脏病学评估，通过心肌灌注成像 (MPI) 检测到无症状的严重心肌缺血。心肌缺血归因于冠状微血管功能障碍，发生在戒掉非法药物数年后。这项研究强调了既往饮酒和使用非法药物的患者可能发生的潜在心肌缺血，以及 MPI 的作用，MPI 是一种非侵入性测试，可以提供有关此类患者心肌状态的重要信息，