Cardiac Complications of Adult Methamphetamine Exposures

• Published in: The Journal of emergency medicine Vol. 45; no. 6; pp. 821 - 827
• Main Authors: Hawley, Lesley A., MD, Auten, Jonathan D., DO, Matteucci, Michael J., MD, Decker, Lawrence, MD, Hurst, Nicole, MD, Beer, William, MD, Clark, Richard F., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2013
• Subjects: acute coronary syndromes; Adult; Amphetamine-Related Disorders - complications; Amphetamine-Related Disorders - epidemiology; Amphetamine-Related Disorders - physiopathology; Blood Pressure - physiology; cardiac complications; Cardiovascular Diseases - chemically induced; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - physiopathology; Electrocardiography; Emergency; Female; Heart Rate - physiology; Humans; illicit drug ingestion/poisoning; Incidence; Male; methamphetamine; Methamphetamine - adverse effects; Retrospective Studies; toxicity; Troponin - blood; United States - epidemiology; United States; toxicity; cardiac complications; illicit drug ingestion/poisoning; methamphetamine; acute coronary syndromes
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/j.jemermed.2013.04.061

Abstract Background Methamphetamine use is an increasing problem in the United States. Despite the similarities to cocaine in clinical presentation, methamphetamine effects on the cardiovascular system are not as clearly understood. Objectives The purpose of this retrospective review is to evaluate the cardiovascular outcomes of methamphetamine exposures reported to both the California Poison Control System (CPCS) and two Level 1 trauma centers. Methods CPCS records from 2000−2009, as well as inpatient and emergency department charts from two Level 1 trauma centers during the time frame of 2000−2004 were reviewed. Charts of adults with coded methamphetamine exposures were included. Results Records of 2356 adults with methamphetamine exposure were assigned levels of severity according to National Poison Data System Medical Outcomes Criteria. Out of the combined charts reviewed from the CPCS data and hospital registries, 584 cases were coded as minor effects, 450 as moderate effects, 208 as major effects, and 28 as deaths. Of the included 1270 cases, 627 electrocardiograms (ECGs) were analyzed. Together, troponins and ECGs showed evidence of myocardial ischemia in 82 total cases, which is 6.5% of the cases reviewed. Cocaine was a co-ingestant in 10 of the 82 cases. Conclusions This study presents a large cohort of methamphetamine users. The study found that chest pain and myocardial ischemia were reported in a number of cases. Although no true incidence can be taken from this dataset, it provides a large-scale review of methamphetamine use and its possible association with acute coronary syndromes.