[Acute myocardial infarct caused by nicotine-induced erythrocytosis]

Area of Science:

• Cardiology
• Hematology
• Toxicology

Background:

• Heavy smoking is a significant risk factor for cardiovascular disease.
• Erythrocytosis, or elevated hematocrit, can increase blood viscosity and thrombotic risk.

Observation:

• A 29-year-old male heavy smoker presented with acute myocardial infarction.
• His hematocrit was severely elevated at 70%.

Findings:

• Coronary angiography revealed complete occlusion of the right coronary artery.
• Intracoronary urokinase successfully restored normal coronary blood flow.
• Other causes of erythrocytosis were ruled out, with heavy smoking identified as the likely cause.

Implications:

• This case highlights a rare but serious complication of heavy smoking: smoking-induced erythrocytosis leading to acute myocardial infarction.
• It underscores the importance of considering hematological abnormalities in young patients presenting with myocardial infarction.
• Aggressive smoking cessation counseling is crucial for preventing such thrombotic events.