Chatterjee Arjun, Crane Alejandro Duran, Olt Caroline, Freiberg Marina
Department of Internal medicine Cleveland Clinic.
Department of Cardiology, Heart, Vascular and Thoracic Institute Cleveland Clinic.
Brown J Hosp Med. 2023 Apr 1;2(2):73233. doi: 10.56305/001c.73233. eCollection 2023.
Methylphenidate (MPH) is a sympathomimetic stimulant used to manage adult narcolepsy and attention deficit hyperactivity disorder (ADHD), which is frequently abused. We present the case of a 37-year-old female who developed acute right ventricle (RV) failure after the self-injection of IV MPH. While difficult to prove causation, the temporal relationship between self-injection and symptom onset suggests a role for MPH in this patient's acute RV failure. Other causes for acute RV failure were ruled out: she had no prior history of PH, ECG was not consistent with ischemia, computed tomography angiography (CTA) was negative for pulmonary embolism (PE), and Right heart catheterization (RHC) was not consistent with left ventricular failure. While there are case reports of persistent PH with chronic IV MPH use, this case describes the only reported incident of transient acute RV failure after IV MPH use.
哌甲酯（MPH）是一种拟交感神经兴奋剂，用于治疗成人发作性睡病和注意力缺陷多动障碍（ADHD），该药常被滥用。我们报告了一例37岁女性在自行静脉注射MPH后发生急性右心室（RV）衰竭的病例。虽然很难证明因果关系，但自行注射与症状发作之间的时间关系表明MPH在该患者急性RV衰竭中起了作用。其他导致急性RV衰竭的原因已被排除：她既往无肺动脉高压病史，心电图与缺血不符，计算机断层血管造影（CTA）显示肺栓塞（PE）阴性，右心导管检查（RHC）与左心室衰竭不符。虽然有关于长期静脉使用MPH导致持续性肺动脉高压的病例报告，但本病例描述了静脉使用MPH后唯一报告的短暂性急性RV衰竭事件。
