Amphetamine-associated cardiovascular lesions

Abstract

The number of drug users in recent years has progressively increased worldwide. Many of them develop drug addiction, which needs specialized treatment. Mortality due to drug use has increased significantly.The results of our own observation were presented of a patient aged 30 years hospitalized in the cardiological resuscitation department of Oleksandrivska Clinical Hospital with complaints of intense pain in the chest of a burning character with radiation to the left arm and interscapular region, an episode of fever up to 39 °C, chills, which preceded the chest pain after drinking alcohol and 0.5 g of methamphetamine. According to laboratory and instrumental examination, including magnetic resonance imaging, the diagnosis of acute toxic myopericarditis was made.Amphetamine and its derivatives belong to the class of central nervous system stimulants that act through effect on neurotransmitters: an increase in the release of dopamine, norepinephrine and serotonin from presynaptic nerve endings with inhibition of their reuptake. The effects of amphetamine on the body depend mainly on the amount of amphetamine consumed. It acts indirectly as a sympathomimetic which stimulates the release of norepinephrine from the sympathetic nerves, causes spasm of the coronary arteries and myocardial ischemia, as well as life‑threatening arrhythmias. Amphetamine can also act as a trigger for an active inflammatory response with the development of toxic myocarditis or myopericarditis. Treatment of acute amphetamine‑induced heart damage involves antianginal therapy (nitroglycerin and calcium channel blockers), antiplatelet therapy, anticoagulants (in case of thrombotic occlusion). Beta‑blockers are not indicated due to the risk of increased a‑stimulation and vasospasm.