Amphetamine-associated ventricular tachycardia leading to out-of-hospital cardiac arrest in a patient with ADHD: A case report

Abstract

BackgroundThis case report describes a 32-year-old male with a history of attention deficit hyperactivity disorder (ADHD) who suffered an out-of-hospital cardiac arrest due to V-tach, attributed to amphetamine use. The patient's medical history revealed no conventional cardiovascular risk factors. Case presentationThe patient was found unresponsive at home and received prehospital care from EMS, leading to the return of spontaneous circulation (ROSC) before hospital arrival. Diagnostic evaluation revealed severe left ventricular systolic dysfunction (EF <30%) and nonischemic cardiomyopathy. The cardiology team initiated Impella support for hemodynamic management. The patient subsequently experienced another V-tach episode, which was treated with amiodarone and lidocaine drips. The patient was moved to a more advanced medical facility to be evaluated for the potential need for a left ventricular assist device or heart transplantation. ConclusionThe lessons learned from this case could aid in the development of evidence-based guidelines for the monitoring of cardiac function in patients prescribed amphetamines for ADHD and contribute to improved patient outcomes in this population. As the prevalence of ADHD diagnoses and stimulant medication use continues to rise, awareness of the potential cardiovascular implications is paramount in the pursuit of safe and effective treatment strategies for patients with ADHD. Further research and collaboration between cardiology and psychiatry fields are essential to better comprehend the nuances of this association and inform clinical decision-making to prevent future occurrences of amphetamine-associated cardiac complications.