Abstract
-amine-induced dilated cardiomyopathywas referred from clinic to the emer-gency department after having had anepisode of chest pain during his clinicvisit. The patient reported exertional chest discomfort,described as a pressurelike sensation accompanied bysweating.Thediscomfortresolvedwithrestandsublin-gual nitroglycerin. He admitted to recent methamphet-amine use. His blood pressure was 136/70 mm Hg, andhis heart rate was regular at 99 beats/min. The jugularvenous pressure was mildly elevated, and an S3 gallopwas audible at the apex. His initial troponin-I level was0.10 ng/mL (normal !0.10 ng/mL). An electrocardio-gram (ECG) showed normal sinus rhythm and left ven-tricular hypertrophy with associated repolarizationabnormalities.Thepatientwasadmittedtothehospitalforserialcar-diacenzymedeterminations.Onthesecondhospitalday,the patient suddenly became profusely diaphoretic andcomplained of chest pain. An ECG was obtained(
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