CASE REPORT
Methamphetamine Use Associated With Monomorphic Ventricular Tachycardia Jing Li, MD, Jiong Li, PhD, Yuhua Chen, BSN, Ying Xu, BSN, Weiping Li, BSN, Yuting Chen, MD, and Kaijun Cui, MD
(J Addict Med 2014;8: 470–473)
T
he excessive use of methamphetamine (MA), an illicit drug in widespread global use based on the 2013 World Drug Report, results in mental and physical health problems. More specifically, MA exposure may induce cardiac arrhythmias, cardiomyopathy, heart failure, and even sudden death. Cardiac arrhythmias, such as QT prolongation and nonspecific ST-T changes, are commonly associated with MA use (Haning & Goebert, 2007). Here, we report the first case of a young man who had no signs or family history of structural heart disease and presented with monomorphic ventricular tachycardia (VT) after smoking MA.
CASE REPORT A 30-year-old Chinese man (weight, 50 kg; height, 170 cm) with no history of palpitation or syncope presented with tachycardia, chest discomfort, dizziness, fatigue, nausea, and vomiting 12 hours after smoking about 200 mg of MA. He had no symptoms of chest pain, amaurosis, or syncope. He was sent to a local hospital immediately, and an electrocardiogram (ECG) revealed VT. Amiodarone was injected intravenously to control the heart rate and terminate the VT. However, the ECG indicated continuing VT, prompting the transfer of the patient to our emergency department. His initial vital signs at our emergency department were as follows: heart rate, 224 beats/min; blood pressure, 119/86 mm Hg; respiratory rate, 20 breaths/min; and body temperature, 36.5◦ C. Physical examination was unremarkable except for tachycarFrom the Institute of Clinical Medicine (JL), West China Medical School of Sichuan University, Chengdu, China; State Key Laboratory of Biotherapy (JL), West China Hospital of Sichuan University, Chengdu, China; Department of Cardiology (YC, YX, WL, KC), West China Hospital of Sichuan University, Chengdu, China; and Department of Cardiology (YC), The People’s Hospital of Yuyao, Zhejiang, China. Received for publication April 17, 2014; accepted June 09, 2014. Supported by the Technology Support Program of Science and Technology, Department of Sichuan Province, China (2012SZ0038). The authors declare no conflicts of interest. Jing Li, Jiong Li, and Yuhua Chen contributed equally to this work. Send correspondence and reprint requests to Kaijun Cui, MD, Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China. E-mail: [email protected]. C 2014 American Society of Addiction Medicine Copyright ISSN: 1932-0620/14/0806-0470 DOI: 10.1097/ADM.0000000000000069
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dia. ECG performed in our emergency department also revealed VT (Fig. 1) with monomorphic morphology and a heart rate of 224 beats/min. Intravenous treatment with 70 mg of propafenone was given immediately and cardioversion was successfully gained after 10 minutes, although dopamine was required to maintain his blood pressure (Fig. 2). Subsequent laboratory tests for myocardiac biomarkers indicated a peak myoglobin of 586.9 ng/mL, a peak creatine kinaseMB of 181.4 ng/mL, and a troponin T level of 3846.0 ng/L (reference values were 28.0-72.0 ng/mL,
Methamphetamine Use Associated With Monomorphic Ventricular Tachycardia Jing Li, MD, Jiong Li, PhD, Yuhua Chen, BSN, Ying Xu, BSN, Weiping Li, BSN, Yuting Chen, MD, and Kaijun Cui, MD
(J Addict Med 2014;8: 470–473)
T
he excessive use of methamphetamine (MA), an illicit drug in widespread global use based on the 2013 World Drug Report, results in mental and physical health problems. More specifically, MA exposure may induce cardiac arrhythmias, cardiomyopathy, heart failure, and even sudden death. Cardiac arrhythmias, such as QT prolongation and nonspecific ST-T changes, are commonly associated with MA use (Haning & Goebert, 2007). Here, we report the first case of a young man who had no signs or family history of structural heart disease and presented with monomorphic ventricular tachycardia (VT) after smoking MA.
CASE REPORT A 30-year-old Chinese man (weight, 50 kg; height, 170 cm) with no history of palpitation or syncope presented with tachycardia, chest discomfort, dizziness, fatigue, nausea, and vomiting 12 hours after smoking about 200 mg of MA. He had no symptoms of chest pain, amaurosis, or syncope. He was sent to a local hospital immediately, and an electrocardiogram (ECG) revealed VT. Amiodarone was injected intravenously to control the heart rate and terminate the VT. However, the ECG indicated continuing VT, prompting the transfer of the patient to our emergency department. His initial vital signs at our emergency department were as follows: heart rate, 224 beats/min; blood pressure, 119/86 mm Hg; respiratory rate, 20 breaths/min; and body temperature, 36.5◦ C. Physical examination was unremarkable except for tachycarFrom the Institute of Clinical Medicine (JL), West China Medical School of Sichuan University, Chengdu, China; State Key Laboratory of Biotherapy (JL), West China Hospital of Sichuan University, Chengdu, China; Department of Cardiology (YC, YX, WL, KC), West China Hospital of Sichuan University, Chengdu, China; and Department of Cardiology (YC), The People’s Hospital of Yuyao, Zhejiang, China. Received for publication April 17, 2014; accepted June 09, 2014. Supported by the Technology Support Program of Science and Technology, Department of Sichuan Province, China (2012SZ0038). The authors declare no conflicts of interest. Jing Li, Jiong Li, and Yuhua Chen contributed equally to this work. Send correspondence and reprint requests to Kaijun Cui, MD, Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China. E-mail: [email protected]. C 2014 American Society of Addiction Medicine Copyright ISSN: 1932-0620/14/0806-0470 DOI: 10.1097/ADM.0000000000000069
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dia. ECG performed in our emergency department also revealed VT (Fig. 1) with monomorphic morphology and a heart rate of 224 beats/min. Intravenous treatment with 70 mg of propafenone was given immediately and cardioversion was successfully gained after 10 minutes, although dopamine was required to maintain his blood pressure (Fig. 2). Subsequent laboratory tests for myocardiac biomarkers indicated a peak myoglobin of 586.9 ng/mL, a peak creatine kinaseMB of 181.4 ng/mL, and a troponin T level of 3846.0 ng/L (reference values were 28.0-72.0 ng/mL,
