Ecstasy-Induced Acute Myocardial Infarction Unraveled by Multimodality Imaging.

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.