Ecstasy-induced myocardial infarction in a teenager: rare complication of a widely used illicit drug

Møller, Michael; Völz, Jens; Paliege, R; Lenz, Corinna; Gradaus, Rainer; Neuzner, Jörg

doi:10.1007/s00392-010-0205-z

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…The typical clinical presentation is one of an acute coronary syndrome with sudden‐onset chest pain, which can be the result of progression of atheromatous narrowing, vasospasm, plaque instability with thrombus formation, increased myocardial oxygen demand and direct myocyte toxicity . It is likely that the majority of cases are the result of sympathomimetic‐induced vasospasm of coronary arteries , but acute myocardial infarction as a result of plaque rupture and thrombus formation is the cause of angina symptoms in a significant minority of cases, and this is more likely to be the case following cocaine consumption, given its prothrombotic action .…”

Section: Chronic Conditionsmentioning

confidence: 99%

Psychostimulant use disorder and the heart

Duflou

2019

Addiction

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Psychostimulants are a diverse range of substances that encompass cocaine and the phenylethylamines, the latter including the amphetamines, cathinones and some ‘novel psychoactive substances’. This paper examines the range of pathophysiological processes, clinical presentations and treatment options involving the heart and cardiovascular system both in the acute setting and where long‐term effects of psychostimulant use have affected the cardiovascular system. A common feature of these drugs is their effect on the cardiovascular system, where their major action is that of sympathomimetic amines with short‐ and long‐term stimulation of the adrenergic system and consequent effects on blood pressure, cardiac modelling, atherogenesis and cellular calcium signalling. Cocaine additionally exhibits a variety of prothrombotic effects, effects on inflammatory mediators and alterations in myocardial gene expression. Persistent psychostimulant use results in progressive cardiovascular pathology, largely in the form of accelerated atherosclerosis, hypertension and myocardial ischaemia. Abstinence results in at least partial reversal of pathology. To a large extent, an assumption is made that treatment protocols used for cocaine‐associated cardiovascular pathology apply to the amphetamines and other phenylethylamines, but there appears to be little research in this area, despite acknowledgement that cocaine and the better‐known amphetamines have different modes of action.

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Section: Chronic Conditionsmentioning

confidence: 99%

Psychostimulant use disorder and the heart

Duflou

2019

Addiction

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Toxic Ingestions

Sullivan

McDonald

2014

Pediatric Critical Care Medicine

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IntroductionEven with public heightened awareness for potential home toxin exposures, poisonings continue to occur and pose a signifi cant challenge to the pediatric intensivist. In 2009, United States Poison Control centers reported 1,613,272 toxin exposures in children less than 20 years of age [ 1 ]. This represented 65 % of all reported human exposures. Children younger than 3 years were involved in 38.9 % of exposures and children younger than 6 years accounted for just over half of all human exposures (51.9 %). The three most common exposures in children age 5 years or younger were cosmetics/personal care products (13.0 %), analgesics (9.7 %), and household cleaning substances (9.3 %). Despite the majority of human exposures being in the pediatric age group, only 79 (6.8 %) of the 1,158 human deaths were in those less than 20 years of age. As expected, unintentional toxin exposures were more prevalent in children younger than 13 years of age (99.2 %) compared to teenagers (47 %) [ 1 ]. The intensivist must be prepared to care for the children who have serious and sometimes life-threatening exposures. AbstractDespite the public's heightened awareness of potential toxin exposures in children, poisonings continue to occur and pose a signifi cant challenge to the pediatric intensivist. In 2009, the United States Poison Control centers reported 1,613,272 toxin exposures in children less than 20 years of age which represented 65 % of all reported human exposures. Children younger than 3 years were involved in 38.9 % and children younger than 6 years accounted for just over half of all human exposures (51.9 %). The three most common exposures in children age 5 years or younger were cosmetics/personal care products (13.0 %), analgesics (9.7 %), and household cleaning substances (9.3 %). Despite the majority of human exposures being in the pediatric age group, only 79 (6.8 %) of the 1,158 human deaths were in those less than 20 years of age. As expected, unintentional toxin exposures were more prevalent in children younger than 13 years of age (99.2 %) compared to teenagers (47 %). The intensivist must be prepared to care for children who have serious and sometimes life-threatening exposures. Supportive care is the mainstay of therapy because many poisons have no specifi c antidote. Much of the current clinical practices for treating the poisoned patient are based on anecdotal reports because there are limited evidenced-based clinical trials that provide guidance for treatment, safety, and outcome.

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