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苯丙胺-右旋苯丙胺所致心肌病:一名年轻成瘾者心力衰竭的病例报告。

Amphetamine-Dextroamphetamine-Induced Cardiomyopathy: A Case Report on Heart Failure in a Young Addict.

作者信息

Al-Juhani Abdulkreem, Alyaseen Eman M, Aseri Saeed, Alghamdi Omar M

机构信息

Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU.

College of Medicine and Medical Science, Arabian Gulf University, Manama, BHR.

出版信息

Cureus. 2024 Oct 7;16(10):e71044. doi: 10.7759/cureus.71044. eCollection 2024 Oct.

Abstract

In teenagers and young adults, dextroamphetamine-induced cardiomyopathy is becoming a more common cause of heart failure. More patients are at risk of this cardiac manifestation due to the medication's increased use in the treatment of attention-deficit/hyperactivity disorder (ADHD), particularly those who are unaware of the risks associated with using it improperly to improve concentration for poor performance. It becomes imperative to draw attention to the link between heart failure and amphetamine-dextroamphetamine usage to raise awareness of this illness. This case study revolves around a 32-year-old man with a complicated medical history who was recently diagnosed with heart failure with reduced ejection fraction (HFrEF < 10%), which was linked to amphetamine-induced cardiomyopathy. His recent diagnosis of ADHD and the treatment that followed raise questions regarding the potential for drug-induced worsening of underlying cardiomyopathy. To address his cardiac and concomitant issues, the patient is currently on a complete pharmaceutical regimen that includes atorvastatin, aspirin, furosemide, spironolactone, enoxaparin, omeprazole, and carvedilol. To maximize results and stop additional cardiac deterioration, patients with dual diagnoses, especially those involving amphetamine use and preexisting cardiac conditions, need to be carefully monitored and managed by a multidisciplinary team.

摘要

在青少年和年轻成年人中,右旋苯丙胺所致心肌病正成为心力衰竭越来越常见的病因。由于该药物在治疗注意力缺陷多动障碍(ADHD)中的使用增加,更多患者面临这种心脏表现的风险,尤其是那些未意识到不当使用该药物以提高因表现不佳导致的注意力而带来的风险的患者。必须关注心力衰竭与苯丙胺 - 右旋苯丙胺使用之间的联系,以提高对这种疾病的认识。本病例研究围绕一名有复杂病史的32岁男性展开,他最近被诊断为射血分数降低的心力衰竭(HFrEF < 10%),这与苯丙胺所致心肌病有关。他最近被诊断出患有ADHD以及随后的治疗引发了关于药物导致潜在心肌病恶化可能性的问题。为解决他的心脏及伴随问题,该患者目前正在接受完整的药物治疗方案,包括阿托伐他汀、阿司匹林、呋塞米、螺内酯、依诺肝素、奥美拉唑和卡维地洛。为使治疗效果最大化并阻止心脏进一步恶化,患有双重诊断的患者,尤其是那些涉及使用苯丙胺和已有心脏疾病的患者,需要由多学科团队进行仔细监测和管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4523/11540963/ae336be2ab07/cureus-0016-00000071044-i01.jpg

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