A 29-year-old woman presented at her local hospital with acute chest pain 2 days after she went to a techno party. Transthoracic echocardiography revealed left ventricular hypokinesia of the apical segments with normal ejection fraction. Cardiac valves were unremarkable (Supplementary material online, S1). After ruling-out pulmonary embolism and pneumothorax with computed tomography (CT), she was admitted to our hospital on the same day for coronary catheterization because of elevated cardiac enzymes (hs-troponin-T levels: 1599 ng/mL, myoglobin: 373 µg/L, creatine kinase: 1601 U/L). Catheter coronary angiography was highly suspicious of a spontaneous coronary artery dissection (type III, focal stenosis) in the mid-left anterior descending coronary artery (Panel A), being compatible with the echocardiography wall motion abnormalities. Since the flow distal to the dissection was normal [thrombolysis in myocardial infarction (TIMI) grade flow 3], no intervention was performed. The right coronary artery was normal. Toxicology screening showed positive urinary levels for amphetamine, benzodiazepine, and cannabis.

中文翻译：

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苯丙胺引起的冠状动脉夹层和大主动脉瓣血栓。

一名29岁妇女在参加Techno派对2天后，在当地医院出现了急性胸痛。经胸超声心动图检查发现心尖射血分数正常的心尖段左心室运动功能减退。心脏瓣膜无异常（在线补充材料，S1）。在用计算机断层扫描（CT）排除肺栓塞和气胸后，由于心脏酶升高（hs-肌钙蛋白-T水平：1599 ng / mL，肌红蛋白：373 µg），她于同日入院接受冠状动脉插管术。 / L，肌酸激酶：1601 U / L）。导管冠状动脉造影高度怀疑左中前降支冠状动脉（图A）中的自发性冠状动脉解剖（III型，局灶性狭窄），与超声心动图壁运动异常兼容。由于解剖远端的血流正常[心肌梗死（TIMI）级血栓溶解3]，因此未进行干预。右冠状动脉正常。毒理学筛查显示苯丙胺，苯二氮卓和大麻的尿液阳性。