evaluated the spectrum of the acute CVE to our cardiology polyclinic outpatiently. Material-Method: We retrospectively evaluated the medical re- cordings of the patients who admitted with CVE and their clinical features and the management of them. We reviewed the medical ar- chives of the patients who were examined during the one year period of 2011. Results: We observed that 21 patients with acute CVE were iden- tified during the clinical and echocardiographic examination, and ex- ercise stress test. Acute coronary syndromes (ACS) and new onset LBBB on stress test are the predominantly encountered CVEs in pa- tients >35 years old while decompensated heart failure with reduced ejection fraction, pneumothorax mostly observed in patients <35 years old. Patients were mostly transferred initially to the ER and then the coronary care unit of a tertiary health service. Conclusion: Cardiovascular Emergencies including acute coronary syndrome or new onset left bundle branch block, symptomatic hypo- tension, and etc. could be presented directly to the cardiology polyclinic or develop de novo during the exercise test unit. Subsequently they should be initially intervened and managed in polyclinic by acute medication or CPR, and transfer to ER or CCU. Utility of ECG and echocardiography either alone or in combination just during the initial examination and interrogation of a symptomatic patient will be preferred rather than giving an appointment to them. Localization of cardiology outpatient services next to the ER and/or CCU will improve the effectiveness of initial management of patients who admitted with potentially lethal CVEs. Additionally cardiology polyclinics should have the capability and instrumentation to apply a medical and inter- ventional resuscitation. - PP-013 Endothelial Dissection due to the Usage of Synthetic Cannabinoid: Bonsai. Hakan Ozkan 1 , Ahmet Seckin Cetinkaya 1 , Hasan Ari 2 , Selma Kenar Tiryakioglu 4 , Tahsin Bozat 3 . 1 Department of Cardiology, Bahcesehir University, Istanbul, Turkey; 2 Department of Cardiology, yuksek ihtisas Hospital, Bursa, Turkey; 3 Department of Cardiology, Medicalpark Hospital, Bursa, Turkey; 4 Department of Cardiology, Bursa State Hospital, Bursa, Turkey. Introduction: The usage of synthetic cannabinoids became very pop- ular in young adults. Bonsai is one of the most common cannabinoid in our country. There are several side effects described including convulsion, hypotension, angina pectoris, myocardial infarction(MI). In this case we aimed to report myocardial infarction which is caused by endothelial dissection and thrombus formation immediately after bonsai usage. Case Description: 25-year-old male presented with sudden onset chest pain with a history bonsai usage 90 minutes ago. Electrocardi- ography demonstrated acute anterior MI. Urgent coronary angiography was performed. Coronary angiography revealed total occlusion of distal left anterior descending artery(LAD) with an intense thrombus located at the proximal LAD. PTCA was performed with a 2.0x20 mm balloon. There was no flow after PTCA. Therefore we used Medtronic export catheter for thrombus aspiration. Thrombus was aspirated and tirofiban was used after PCI. The patient was discharged after 5 days with ase- tylsalicylic acid, ticagrelor beta blocker and ACEI. One month later control coronary angiography was performed. Control angiography was completely normal. The patient was stopped using asetylsalicylic acid and ticagrelor himself when angiography showed normal coronary anatomy. 5 days later patient was admitted to emergency department Figure. Diagnosis of case presented with cardiovascular emergencies and further diagnostic and therapeutic procedures and their variation according to the age < and > 35 years old. Table: Duration of Complaint Several Hours 9 (42.9%) At least a day 7 (33.3%) Several days 5 (23.8%) Diagnostic Tool ECG 9 (42.9%) Echocardiography 3 (14.3%) ECGþEchocardiography 5 (23.8%) Exercise Stress Test 2 (9.5%) Telecardiography 2 (9.5%) Echocardiographic Findings Normal LVEF 15 (71.4%) Reduced LVEF 2 (9.5%) Reduced LVEF with LV dilatation 2 (9.5%) LV Wall Motion Abnormality 2 (9.5%) Hemodynamic Finding Hypotension/Shock 5 (23.8%) Ventricular Tachycardia/ Fibrillation 1 (4.8%) Hemodynamically Stable 15 (71,4%) Diagnosis Acute Coronary Syndrome 11 (52.4%) New Onset LBBB or ECG Changes on Exercise Test 2 (9.5%) Acute _ Injury due to High Voltage 1 (4.8%) Decompensated Heart Failure with Reduced LVEF 3 (14.3%) Pneumothorax/Pleural Effusion 3 (14.3%) Hypertensive Crisis 1 (4.8%) Transferred Unit Emergency Room 4 (19.0%) CCU on Tertiary Health Service 4 (19.0%) First ER then CCU 13 (61.9%) Further Diagnostic/ Therapeutic Process Coronary Angiography 15 (71.4%) Medical Follow Up on CCU 3 (14.3% Thoracentesis 1 (4.8%) Chest Tube insertion 2 (9.5%) Clinical features of the patients through the management period from the presentation at the cardiology polyclinic to the transfer and management at the tertiary health service. Figure. Coronary angiograms (images with myocardial infarction and control angiography) and OCT images with second heart attack. MARCH 26e29, 2015 S100 The American Journal of Cardiology â MARCH 26e29, 2015 11 th INTERNATIONAL CONGRESS OF UPDATE IN CARDIOLOGY AND CARDIOVASCULAR SURGERY ABSTRACTS / Poster P O S T E R A B S T R A C T S