Lewars Jennaire T, Wiarda Karen P
Internal Medicine, Carle Foundation Hospital, Urbana, USA.
Internal Medicine, Saint James School of Medicine, Chicago, USA.
Cureus. 2023 Jun 25;15(6):e40942. doi: 10.7759/cureus.40942. eCollection 2023 Jun.
Amphetamine-Dextroamphetamine-induced cardiomyopathy has become an emerging cause of heart failure in teenage and young adult populations. With its increasingly widespread use for the treatment of attention-deficit/hyperactivity disorder (ADHD) as well as misuse as a "study drug" to increase concentration for educational performance, more patients are at risk of this cardiac manifestation, especially those without knowledge of these risks. It becomes vital to highlight the correlation of amphetamine-dextroamphetamine use and heart failure in order to increase awareness of this condition. This case study highlights the manifestation of tachycardia-induced cardiomyopathy in a 38-year-old female patient with long-standing amphetamine-dextroamphetamine use for refractory narcolepsy. Our patient was evaluated utilizing a thyroid panel, lipid profiles, EKG, Holter monitoring, stress echocardiography, and left heart catheterization, revealing an unremarkable thyroid panel, a left ventricular ejection fraction (LVEF) of 20-25% from 35% to 40% and normal coronary vessels. Amphetamine-dextroamphetamine was discontinued with the introduction of metoprolol, aspirin, and atorvastatin. The mainstay of treatment includes cessation of amphetamine-dextroamphetamine. It is important that physicians continue to recognize the implication of amphetamine-dextroamphetamine in the diagnosis of non-ischemic cardiomyopathy in young patients presenting with heart failure like symptomology and to attain a comprehensive history in order to establish this diagnosis.
苯丙胺-右旋苯丙胺所致心肌病已成为青少年和青年人群心力衰竭的一个新出现的病因。随着其越来越广泛地用于治疗注意力缺陷/多动障碍(ADHD)以及被滥用作“学习药物”以提高学习成绩时的注意力,更多患者面临这种心脏表现的风险,尤其是那些不了解这些风险的患者。强调苯丙胺-右旋苯丙胺的使用与心力衰竭之间的相关性以提高对这种疾病的认识变得至关重要。本病例研究突出了一名38岁长期使用苯丙胺-右旋苯丙胺治疗难治性发作性睡病的女性患者心动过速性心肌病的表现。我们的患者接受了甲状腺功能检查、血脂谱、心电图、动态心电图监测、负荷超声心动图和左心导管检查,结果显示甲状腺功能检查无异常,左心室射血分数(LVEF)从35%至40%降至20%-25%,冠状动脉血管正常。停用苯丙胺-右旋苯丙胺并开始使用美托洛尔、阿司匹林和阿托伐他汀。治疗的主要方法包括停用苯丙胺-右旋苯丙胺。重要的是,医生要继续认识到苯丙胺-右旋苯丙胺在诊断出现心力衰竭样症状的年轻患者的非缺血性心肌病中的意义,并获取全面的病史以确立该诊断。