A patient with coronary artery disease suffered an acute myocardial infarction temporally related to chewing a betel nut. Alkaloids in betel nut, such as arecoline, may play a contributing role in coronary artery spasm due to parasympathomimetic effects on vessels with abnormal endothelium. Chewing
Areca nut chewing is one of the most prevalent substance abuse habits in the world, and it is associated with the risk of a variety of medical challenges including hypertension, arrhythmia, and coronary artery disease (CAD). However, ST elevation myocardial infarction (STEMI) is an extremely rare