Interv Akut Kardiol. 2005;4(1):45-48

ECSTASY INDUCED ACUTE MYOCARDIAL INFARCTION

Robert Holaj, Tomáš Janota, Jaromír Hradec

III. interní klinika VFN a 1. LF UK, Praha

Introduction: Ecstasy (methylene-3.4-dioxymetamphetamine MDMA) has been gaining popularity as a recreational drug over the past few decades around the globe. Although once thought to be safer than its mother compound, amphetamine, several life-threatening adverse reactions have been reported. However, MDMA-induced acute myocardial infarction is rarely reported.

Case report: We report a case of a 22 year old man, who was admitted to our department for a continual chest pressure shortly after taking two tablets of ecstasy (approximately 120–160 mg of MDMA) within two days of the house party. His ECG showed ST elevation in inferolateral leads. Markers of myocardial necrosis were significantly elevated: Troponin T – 1.9 μg/L; myoglobin – 137 μg/L; creatine kinase – 14.56 U/L and myocardial fraction – 1.53 U/L. Emergency angiography did not find any changes in epicardial coronary arteries. Echocardiography discovered moderate systolic dysfunction (ejection fraction was 0.37). The patient was treated with aspirin, beta-blockers and infusions of nitrates. Before discharging 10 days later, ejection fraction had improved (0.53). In conclusion: MDMA use is emerging as an important drug abuse problem. This case demonstrates that, in young patients without apparent risk factors who present with acute coronary syndromes, drug abuse should be also considered.

Keywords: Key words: acute myocardial infarction, ecstasy, methylene-3.4-dioxymetamphetamine, MDMA.

Published: January 1, 2006  Show citation