Chest Pain in a Young Male with Carbon Monoxide Poisoning and Substance Abuse: A Case Report and Literature Review

BACKGROUND: Carbon monoxide (CO) poisoning is the leading cause of poisoning-related deaths in theUnited 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 followinga 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. Inaddition, cardiac markers were elevated. In this particular instance, thrombolytic therapy demonstratedsuccessful outcomes.CONCLUSIONS: We believe the case and discussion could shed light on the emergency departmentmanagement of such individuals. We advise clinicians to consider the possibility of coronary heart diseasein carbon monoxide poisoning patients and to obtain a baseline electrocardiogram and cardiac markers.