Crystal methamphetamine-associated cardiomyopathy: tip of the iceberg?
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.
Wijetunga
Mevan
M
Department of Medicine, University of Hawaii, Honolulu, Hawaii, USA. mevanwijetunga@yahoo.com
Seto
Todd
T
Lindsay
Joseph
J
Schatz
Irwin
I
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*
D008694:Methamphetamine