title: STEMI Secondary to Coronary Vasospasm: Possible Adverse Event of Methylphenidate in a 21-Year-Old Man with ADHD.
abstract: Methylphenidate (Ritalin®) is an increasingly used medication in the treatment of attention-deficit hyperactivity disorder (ADHD). Cardiovascular adverse effects like vasospasm or myocardial infarction are described as very rare adverse effects. We present the case of a 21-year-old man diagnosed with ADHD who recently started therapy with Ritalin®Adult 20 mg for at least 3 days. Afterwards he presented with chest pain, elevated troponin and creatine kinase, and posterolateral ST elevations. A myocarditis was initially supposed. In the coronary angiography, signs of coronary artery spasm could be found. The echocardiography showed mild left ventricular dysfunction; no acute myocarditis could be found in the cardiac MRI and myocardial biopsy. The medication with methylphenidate was stopped, and after 12 days the asymptomatic patient was discharged from hospital.
authors.affiliation: Medizinische Klinik I, Abteilung für Kardiologie, Elektrophysiologie, Pneumologie und konservative Intensivmedizin, Klinikum Lünen, Altstadtstraße 23, 44534, Lünen, Germany. Timo-Baumeister@gmx.de.
authors.forename: Timo-Benjamin
authors.initials: TB
authors.lastname: Baumeister
authors.affiliation: Medizinische Klinik I, Abteilung für Kardiologie, Elektrophysiologie, Pneumologie und konservative Intensivmedizin, Klinikum Lünen, Altstadtstraße 23, 44534, Lünen, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Wickenbrock
authors.affiliation: Medizinische Klinik I, Abteilung für Kardiologie, Elektrophysiologie, Pneumologie und konservative Intensivmedizin, Klinikum Lünen, Altstadtstraße 23, 44534, Lünen, Germany.
authors.forename: Christian A
authors.initials: CA
authors.lastname: Perings