Cardiovascular Pathologic Changes Due to Methamphetamine Usage

Abstract

Methamphetamine is an extremely addictive stimulant drug that is chemically similar to amphetamine and commonly synthesized illicitly. It has the form of a white, odorless, bitter-tasting crystalline powder, and is taken orally, nasally, smoked, or dissolved in water or alcohol and injected. Smoking or injecting the drug delivers it very quickly to the brain, where it produces an immediate, intense euphoria. Much is known of the physical and psychological effects of methamphetamine on the central nervous system, but there has been little research reported into the cardiovascular pathologic changes. These changes include; acute coronary syndrome, acute myocardial infarction, acute aortic dissection, cardiac arrhythmias, sudden cardiac death, chronic coronary artery disease as well as cardiomyopathy, cardiac apoptosis, cardiac fibrosis, and heart failure. The underlying mechanism of coronary syndrome or acute myocardial infarction after methamphetamine usage is unclear; however, possible causes include coronary artery vasospasm, the rupture of athero-sclerotic plaques and the aggregation of blood platelets, all of which can result in coronary thrombus formation. Similarly, the underlying mechanism of cardiomyopathy or heart failure after methamphetamine usage has yet to be elucidated; however, a possible mechanism other than coronary changes may be chronic methamphetamine-induced cardiac autophagy, apoptosis and fibrosis. Long-lasting and extensive cardiac apoptosis and fibrosis might progressively lead to cardiomyopathy and heart failure. The primary underlying mechanism of sudden cardiac death is cardiac arrhythmia, but pre-existing cardiovascular pathologic changes, such as cardiomyopathy, may predispose methamphetamine users to sudden cardiac death.