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一名年轻成人新发性苯丙胺所致急性失代偿性心力衰竭的管理:病例报告

Management of New Onset Amphetamine-Induced Acute Decompensated Heart Failure in a Young Adult: Case Report.

作者信息

Breier Yuli, Azrak Eli, Banks Wesley, Kushmakov Robert, Aleshinskaya Irina

机构信息

Surgery, Touro College of Osteopathic Medicine, New York City, USA.

Emergency Medicine, Touro College of Osteopathic Medicine, New York City, USA.

出版信息

Cureus. 2023 Aug 21;15(8):e43854. doi: 10.7759/cureus.43854. eCollection 2023 Aug.

Abstract

Amphetamine-induced heart failure is a well-recognized complication of chronic amphetamine abuse. Although the exact mechanisms underlying the development of this condition are not fully understood, it is believed to be due to a combination of direct toxicity to the myocardium, increased sympathetic activity, and oxidative stress. Amphetamine-induced heart failure typically presents with symptoms such as dyspnea, fatigue, and peripheral edema and can lead to significant morbidity and mortality. Diagnosis is based on a combination of clinical and laboratory findings, including echocardiography and cardiac biomarkers. Treatment typically involves cessation of amphetamine use, management of heart failure symptoms, and aggressive medical therapy with agents such as beta-blockers and angiotensin-converting enzyme (ACE) inhibitors. However, the long-term prognosis for patients with amphetamine-induced heart failure remains poor, highlighting the need for increased awareness and prevention efforts surrounding this growing public health concern. In this case, a 21-year-old male presented to the emergency department (ED) with acute-onset decompensated heart failure due to amphetamine abuse.

摘要

苯丙胺所致心力衰竭是慢性苯丙胺滥用一种公认的并发症。尽管导致这种病症发生的确切机制尚未完全明确,但据信是由于对心肌的直接毒性、交感神经活动增加以及氧化应激共同作用所致。苯丙胺所致心力衰竭通常表现为呼吸困难、乏力和外周水肿等症状,可导致显著的发病率和死亡率。诊断基于临床和实验室检查结果的综合判断,包括超声心动图和心脏生物标志物。治疗通常包括停用苯丙胺、控制心力衰竭症状,以及使用β受体阻滞剂和血管紧张素转换酶(ACE)抑制剂等药物进行积极的药物治疗。然而,苯丙胺所致心力衰竭患者的长期预后仍然很差,这凸显了提高对这一日益严重的公共卫生问题的认识并加强预防措施的必要性。在本病例中,一名21岁男性因滥用苯丙胺导致急性失代偿性心力衰竭而就诊于急诊科。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7145/10510945/d6c41a6ca2ed/cureus-0015-00000043854-i01.jpg

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