Document Type : Case Report


1 Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran

2 Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran


BACKGROUND: Carbon monoxide (CO) poisoning is the leading cause of poisoning-related deaths in the
United States. In addition, myocardial infarction (MI) due to CO poisoning in a young, healthy adult is rare.
On the other hand, smokeless tobacco, processed in various forms, is a controversial coronary heart disease
(CHD) risk factor.
CASE REPORT: In this study, we describe a 29-year-old man who presented with acute chest pain following
a night of smoking tobacco and using smokeless tobacco in the presence of carbon monoxide poisoning.
ST-segment elevation was observed on an electrocardiogram, and echocardiography revealed akinesia. In
addition, cardiac markers were elevated. In this particular instance, thrombolytic therapy demonstrated
successful outcomes.
CONCLUSIONS: We believe the case and discussion could shed light on the emergency department
management of such individuals. We advise clinicians to consider the possibility of coronary heart disease
in carbon monoxide poisoning patients and to obtain a baseline electrocardiogram and cardiac markers.


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