A case of acute cardiomyopathy and pericarditis associated with methylphenidate.
Methylphenidate is a potent central nervous system stimulant that exerts its effects by increasing synaptic levels of dopamine and norepinephrine. It has become key to treating attention deficit-hyperactivity disorder (ADHD) in children and adolescents. As the use of stimulant medications has ballooned in the past decade, so too has awareness of the cardiovascular complications of these drugs. Effects on heart rate and blood pressure as well as tachyarrhythmias have been well described. However, acute cardiomyopathy and pericarditis secondary to methylphenidate use has been rarely reported. We report the case of a 17-year-old male who developed chest pain, elevated cardiac biomarkers, and acute left ventricular dysfunction following a single dose of methylphenidate. The risk of cardiomyopathy in the setting of methylphenidate treatment should prompt further study on the safety of this drug, and lead to ways of identifying those at risk of developing these complications.
Dadfarmay
Sina
S
Mercer University School of Medicine, Savannah, GA, USA. zerangi@hotmail.com
Dixon
John
J
D000208:Acute Disease; D000293:Adolescent; D000787:Angina Pectoris / Q000139:chemically induced; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D009202:Cardiomyopathies / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D002317:Cardiovascular Agents / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000009:adverse effects*; D010493:Pericarditis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D018487:Ventricular Dysfunction, Left / Q000139:chemically induced
D002317:Cardiovascular Agents; D000697:Central Nervous System Stimulants; D008774:Methylphenidate