title: Acute myocardial infarction associated with dietary supplements containing 1,3-dimethylamylamine and Citrus aurantium.
abstract: We describe the case of a previously healthy 22-year-old man who presented with anginal chest pain and was diagnosed with a non-ST-elevation myocardial infarction. For 3 weeks, he had been ingesting the dietary supplements Jack3d® (principal ingredient, 1,3-dimethylamylamine) and Phenorex™ (principal ingredient, Citrus aurantium) daily, before undertaking physical activity. Coronary angiograms revealed a proximal left anterior descending coronary artery thrombus with distal embolization. A combined medical regimen led to resolution of the thrombus. Three months later, the patient was asymptomatic with no evidence of ischemia. The primary ingredients in the sympathomimetic supplements taken by our patient are controversial in the medical community and have been individually associated with adverse cardiac events. There are no safety data on their simultaneous use. We discuss other reports of adverse effects associated with these supplements and recommend that the relevant safety guidelines be revised.
authors: Divisions of Cardiology (Drs. Lasorda, Poornima, Smith, and Staub) and Internal Medicine (Dr. Natarajan), Allegheny General Hospital, Pittsburgh, Pennsylvania 15212.
authors: Triston B
authors: TB
authors: Smith
authors: Brian A
authors: BA
authors: Staub
authors: Gayathri M
authors: GM
authors: Natarajan
authors: David M
authors: DM
authors: Lasorda
authors: Indu G
authors: IG
authors: Poornima
mesh_terms: D000588:Amines / Q000009:adverse effects*; D000787:Angina Pectoris / Q000139:chemically induced; D002957:Citrus; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D019587:Dietary Supplements / Q000009:adverse effects*; D000077542:Eptifibatide; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D010455:Peptides / Q000627:therapeutic use; D008517:Phytotherapy; D010936:Plant Extracts / Q000009:adverse effects*; D010946:Plants, Medicinal; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C571979:1,3-dimethylamylamine; D000588:Amines; D010455:Peptides; D010936:Plant Extracts; D010975:Platelet Aggregation Inhibitors; D000077542:Eptifibatide