Myocardial Infarction after Ozone Therapy: Is Ozone Therapy Dr. Jekyll or Mr. Hyde?

Abstract

We discuss the case of a 46-year-old male patient presenting to the emergency department with acute inferior myocardial infarction. Coronary angiography demonstrated a vasospasm of the left main coronary artery and proximal segment of the left anterior descending artery. Furthermore, a thrombotic total occlusion was ascertained in the right coronary artery. The vasospasm in the left main and left anterior descending artery disappeared after nitrate administration. We successfully implanted a stent to the thrombotic occlusion in the right coronary artery after predilatation. On detailed questioning, the patient stated that ozonated autohemotherapy had been applied that morning in a private clinic for the revitalization and regeneration of tissues. The patient did not have any traditional atherosclerotic risk factors. He denied any history of cardiac complaint. Factor V Leiden, prothrombin 20210 and MTHFR a1298c and c677t mutations were investigated and found to be negative except for MTHFR a1298c, which was a heterozygote. The levels of antithrombin III, homocysteine and protein C and S were all within normal ranges. Ozone as a medical therapy has been used in many medical conditions; unfortunately, however, like every other therapy, ozone therapy has side effects. The literature concerning ozone therapy supports possible strong vasoconstrictor and prothrombotic effects of ozone therapy, further supporting our suggestion that ozone can lead to acute coronary syndromes in human beings. In conclusion, to our knowledge, our case report reveals a possible complication of ozone therapy that has never been reported before. We think that this article will raise the awareness of the possibility of thrombotic complications after ozonated autohemotherapy.

Ozonation of Whole Blood Results in an Increased Release of Microparticles from Blood Cells

“…Ozone therapy is considered to be relatively safe. Nevertheless, there are several reports presenting adverse reactions associated with the use of ozone, such as sinus arrest, myocardial infarction, or vasospasm [ 10 , 11 ]. With enhanced exposure to ozone, erythrocytes are increasingly damaged.…”

Ozone therapy induced sinus arrest in a hypertensive patient with chronic kidney disease

“…[ 1 , 2 ] Although a significant effect of ozone therapy has been noted in some diseases, various adverse events have been reported, such as acute coronary syndrome. [ 3 ] Herein, we observed sinus arrest in a hypertension patient with chronic kidney disease (CKD) caused by hyperkalemia after ozone therapy. This case report was approved by the institutional review board of Anzhen Hospital.…”

Ozone Therapy and Its Use in Medicine

“…Finally, Sroczynski et al [4] again reported the opposite of the conclusion of Üreyen et al [1], finding that intra-arterial ozone gas ‘…showed a significant improvement in both groups [atherosclerotic and diabetic patients] manifested by an increase in ankle-arm index, and prolongation of the intermittent claudication distance by more than twice'. The treatment of atherosclerotic ischemia of the lower extremities with O 3 is both valuable and safe.…”

“…We have recently read the report by Üreyen et al [1] on a possible side effect which, by just reading the title, seems unwisely linked to ozone therapy. We feel this report is problematical because of the publication of significant incomplete information and an improper conclusion to wit: ‘…ozone therapy in our case could be the possible etiology of the index myocardial infarction'.…”