Abstract
Exposure to synthetic drugs such as amphetamines may lead to significant consequences
on the cardiovascular system. The prognosis of young adults with amphetamine-induced
cardiomyopathy remains poor. We present 2 young patients (aged <40 years) who developed
severe dilated cardiomyopathy after chronic amphetamine use. Thorough psychological
evaluations demonstrated favorable features with patients being reliable and committed
to their health problems. A left ventricular assist device (HeartMate II; Abbott,
Chicago, IL) was implanted in the patients shortly after admission to optimize hemodynamic
support and evaluate the potential for recovery. Within less than 1 year, significant
improvement was achieved and successful explantation of left ventricular assist device
was performed in both patients.
Résumé
L’exposition aux drogues de synthèse, telles les amphétamines, peut avoir des conséquences
graves sur le système cardiovasculaire. Le pronostic des jeunes adultes ayant une
cardiomyopathie liée aux amphétamines demeure mauvais. Nous présentons deux cas de
patients jeunes (< 40 ans) qui ont développé une cardiomyopathie dilatée grave après
une consommation prolongée d’amphétamines. Des évaluations psychologiques approfondies
ont démontré des caractéristiques favorables en raison de la fiabilité des patients
et de leur engagement à résoudre leurs problèmes de santé. Un dispositif d’assistance
ventriculaire gauche (HeartMate II, Abbott, Chicago, IL) a été implanté chez les patients
peu après leur admission pour optimiser la suppléance hémodynamique et évaluer le
potentiel de rétablissement. En moins d'un an, d’importantes améliorations ont été
obtenues et l’explantation des dispositifs d’assistance ventriculaire gauche s’est
avérée une réussite chez les deux patients.
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References
- The cardiac complications of methamphetamines.Heart Lung Circ. 2016; 25: 325-332
- Clinical characteristics and outcomes of patients with amphetamine-associated cardiomyopathy in South Auckland, New Zealand.Heart Lung Circ. 2016; 25: 1087-1093
- Polymorphism in CYP2D6 may predict methamphetamine related heart failure.Clin Toxicol. 2013; 51: 540-544
- Clinical characteristics, histopathological features, and clinical outcome of methamphetamine-associated cardiomyopathy.JACC Heart Fail. 2017; 5: 435-445
- Cardiac magnetic resonance as an alternative to endomyocardial biopsy to predict recoverability of left ventricular function in methamphetamine-associated cardiomyopathy.JACC Heart Fail. 2017; 5: 853-854
Article info
Publication history
Published online: October 12, 2019
Accepted:
September 15,
2019
Received:
March 10,
2019
Footnotes
See page 317.e7 for disclosure information.
Identification
Copyright
© 2019 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
