Methamphetamine-induced myocardial infarction with elevated troponin I

2014 AHA/ACC Guideline for the Management of Patients With Non–ST-Elevation Acute Coronary Syndromes

“…131,749,750 Methamphetamines may be ingested orally, inhaled, or used intravenously. Methamphetamine affects the central nervous system by simultaneously stimulating the release and blocking the reuptake of dopamine and norepinephrine.…”

“…751 Like cocaine, methamphetamine exerts multiple effects on the cardiovascular system, all of which may precipitate ACS. 131,[750][751][752] The acute effects of methamphetamine are euphoria, tachycardia, hypertension, and arrhythmias. MI may result from coronary spasm or plaque rupture in the presence of enhanced platelet aggregation.…”

“…Long-term use of methamphetamine has been associated with myocarditis, necrotizing vasculitis, pulmonary hypertension, and cardiomyopathy. [750][751][752] Because methamphetamine and cocaine have similar pathophysiological effects, treatment of patients with ACS associated with methamphetamine and cocaine use should theoretically be similar.…”

2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction

“…Currently, the evidence base for UA/NSTEMI after methamphetamine and its treatment is limited to a few publications of case reports and small series. [885][886][887][888] These suggest that ACS is increasingly common in patients evaluated in the ED for chest discomfort after methamphetamine use and that the frequency of other potentially life-threatening arrhythmias is not negligible. 886 Clinical presentation resembles that of cocaine-associated ACS.…”

2012 ACCF/AHA Focused Update Incorporated Into the ACCF/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction

“…Currently, the evidence base for UA/NSTEMI after methamphetamine and its treatment is limited to a few publications of case reports and small series. [1029][1030][1031][1032] These suggest that ACS resolves when the chest discomfort abates. Typically, NTG is exquisitely effective in relieving the spasm.…”