title: Crystal methamphetamine-associated cardiomyopathy: tip of the iceberg?
abstract: BACKGROUND
  Crystal methamphetamine has become a drug of widespread use. Previous reports describe myocardial infarction, pulmonary edema, and aortic dissection related to methamphetamine use. Cardiomyopathy due to methamphetamine exposure has been rarely described.
  
  
  METHODS
  We identified 1640 patients admitted in a 4-yr period with a primary or secondary diagnosis of cardiomyopathy. We excluded patients with known cause of cardiomyopathy other than substance abuse. We found 120 patients had a diagnosis of substance abuse, including 21 patients with methamphetamine use. We retrospectively reviewed the medical records of these 21 crystal methamphetamine users.
  
  
  RESULTS
  Nineteen (84%) underwent echocardiography with consistent findings of dilated cardiomyopathy and global ventricular dysfunction. Of five who had a nuclear myocardial perfusion study, none had evidence of ischemia or infarct. Of six who underwent cardiac catheterization, only one had evidence of coronary stenosis.
  
  
  CONCLUSIONS
  Methamphetamine use appears to produce cardiomyopathy in some users. The pathogenesis is probably similar to that of cocaine and catecholamine-induced cardiomyopathy. Cellular, animal, and clinical data support the link between methamphetamine exposure and myocardial pathology.
authors.affiliation: Department of Medicine, University of Hawaii, Honolulu, Hawaii, USA. mevanwijetunga@yahoo.com
authors.forename: Mevan
authors.initials: M
authors.lastname: Wijetunga
authors.forename: Todd
authors.initials: T
authors.lastname: Seto
authors.forename: Joseph
authors.initials: J
authors.lastname: Lindsay
authors.forename: Irwin
authors.initials: I
authors.lastname: Schatz
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008694:Methamphetamine / Q000506:poisoning*; D008875:Middle Aged; D019966:Substance-Related Disorders / Q000150:complications*
chemical_list: D008694:Methamphetamine