Intratracheal cocaine induced myocardial infarction: an unusual complication of fibreoptic bronchoscopy
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Updated: Aug 4, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
S Osula1, P Stockton, M M Abdelaziz
1Cardiology Department, The Cardiothoracic Centre Liverpool, Liverpool, UK. mwalshaw@doctors.org.uk
Abstract:
A 73 year old man developed chest pains 5 minutes after fibreoptic bronchoscopy. The procedure had been performed without sedation following an intratracheal injection of 5 ml 2.5% cocaine solution and xylocaine spray to the pharynx for topical anaesthesia. A 12-lead electrocardiogram showed an evolving anterior myocardial infarction. Cardiac catheterisation revealed coronary artery spasm in the proximal left anterior descending artery at the site of non-significant plaque disease. The risk factors, mechanisms, and treatment of cocaine induced myocardial infarction following intratracheal injections are discussed.
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