title: Intravenous methylphenidate: an unusual way to provoke ST-elevation myocardial infarction.
abstract: Acute ST-T elevation is a sign of myocardial ischemia or infarction usually due to coronary artery atherosclerosis or coronary spasm. Coronary spasm may be spontaneous or can occur as a result of a drug that causes arterial spam. Ritalin, Novartis Pharmaceut. Corporation, USA (methylphenidate hydrochloride), a dopamine reuptake inhibitor,is an oral drug used to treat attention-deficit/hyperactivity disorder and narcolepsy. Sudden deaths, stroke, and myocardial infarction have been reported in adults taking stimulant drugs at usual dose for attention-deficit/hyperactivity disorder [1]. This drug is not supplied as solution for injection [2]. We report here, what we believe to be, the first case report of a 40-year-old male patient who was admitted for acute chest pain and ST-elevation myocardial infarction after intravenous self-injection of Ritalin. His coronary angiogram demonstrated nonobstructive coronary disease.
authors.affiliation: Cardiology Department, Barzilai Medical Center Ashkelon and Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel.
authors.forename: Emile
authors.initials: E
authors.lastname: Hay
authors.affiliation: Cardiology Department, Barzilai Medical Center Ashkelon and Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel.
authors.forename: Vitaly
authors.initials: V
authors.lastname: Shklovski
authors.affiliation: Cardiology Department, Barzilai Medical Center Ashkelon and Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel. Electronic address: yossibl@barzi.health.gov.il.
authors.forename: Yossef
authors.initials: Y
authors.lastname: Blaer
authors.affiliation: Cardiology Department, Barzilai Medical Center Ashkelon and Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Shlakhover
authors.affiliation: Cardiology Department, Barzilai Medical Center Ashkelon and Faculty of Health Sciences, Ben-Gurion University of the Negev, Ashkelon, Israel.
authors.forename: Amos
authors.initials: A
authors.lastname: Katz
mesh_terms: D000328:Adult; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects*; D004562:Electrocardiography / Q000187:drug effects; D004636:Emergency Service, Hospital; D006321:Heart / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000009:adverse effects*; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000503:physiopathology; D019966:Substance-Related Disorders / Q000150:complications
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate