Cardiomyopathy associated with the smoking of crystal methamphetamine

Article Abstract:

Methamphetamine, a drug that stimulates the central nervous system, can induce dependence and can be toxic. The drug can be taken orally, intravenously, or smoked. Within the last several years, there has been an increase in the number of emergency department cases related to the abuse of methamphetamine. Smoking crystal methamphetamine (also called 'ice') has been reported to produce similar effects to those produced by smoking 'crack' cocaine. Methamphetamine abuse has become a significant problem in Asian countries and in Hawaii. Methamphetamine is likely to produce hazardous side effects such as blood vessel spasm, blood clot formation, insufficient blood flow to the heart, and accumulation of fluid in the lungs. However, the health hazards associated with smoking methamphetamine have not been well-documented. The case reports are described of two patients who developed lung and heart problems after smoking methamphetamine. The first patient was a 34-year-old woman who smoked 3.5 grams of methamphetamine a day. The patient had shortness of breath, low blood pressure, increased heart rate, and fluid in the lungs. This patient survived, but with evidence of possible permanent damage to the heart. The second patient was a 31-year-old woman admitted to the hospital without a pulse in her arms and legs. After initial denial of illicit drug use, the patient disclosed a history of smoking crystal methamphetamine. The woman's condition became worse, resulting in a heart attack and death. It is not known how methamphetamine produces toxic effects on the heart, but it is suggested that the drug causes spasms in the blood vessels of the heart, which reduces blood flow to the heart muscle and at the same time makes the heart work harder. These two cases illustrate that the use of illicit drugs should be considered as a potential cause of heart failure in young adults with no prior history of heart disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Drug abuse, Heart failure

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Disposition and pharmacodynamics of methamphetamine in pregnant sheep

Article Abstract:

Methamphetamine (a stimulant, often called 'speed') is a recreational drug that can be ingested intranasally ('snorted'), swallowed, injected, or smoked. Users are typically young white adults with a high school education. Pregnant women who used methamphetamine were found to be more likely to deliver prematurely and have low-birth weight babies. To gain a better understanding of the extent of placental transfer of the drug, its distribution in fetal tissues, and some of the effects on the mother and the fetus, pregnant sheep were injected with methamphetamine. The drug crossed the placenta within 30 seconds and spread to fetal tissues within two and a half minutes. The drug concentration in developing organs, especially the brain, was several times the concentration in fetal plasma, which raises concerns about the effect on the baby after birth. Blood pressure increased significantly in both the ewes and the fetuses, and heart rate fell. This could cause serious complications during pregnancy, when blood pressure normally decreases and heart output increases. Drugs similar to amphetamines cause decreased heart output and circulation in organs, which can lead to lack of oxygen in the fetus, an effect similar to that of cocaine. Among the five to 10 percent of women who develop high blood pressure during pregnancy, the risk of fetal complications and mortality increase; use of methamphetamines may lead to greater fetal abnormalities and also hypertensive crisis. Given the differences between sheep and human anatomy, and the repetitive pattern of drug abuse by pregnant users, the effects may be worse in actual human experience than in this experiment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Models, Drug abuse in pregnancy

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Development of cardiomyopathy in female carriers of Duchenne and Becker muscular dystrophies

Article Abstract:

Women who carry the genetic defect for muscular dystrophy have a high risk of developing heart disease, especially as they age. The muscular dystrophy defect occurs on the X chromosome in the gene that produces the protein dystrophin. Researchers followed 197 female carriers of the muscular dystrophy defect for 3 to 10 years. At each annual examination, electrocardiograms and echocardiograms were included. Heart or skeletal muscle biopsies were taken from 12 of the women. Approximately 10% of the women had heart disease at the start of the study and less than 10% had any evidence of skeletal muscle disease. By the end of the study, 15% of the women 15 years or younger had developed heart disease, but 44.5% of those older than 15 had developed heart disease. Over 56% of those older than 50 with the Duchenne mutation had heart disease and 62.5% of those older than 50 with the Becker mutation had heart disease. Five women died, three of heart failure. Biopsies revealed abnormal dystrophin in the myocardial fibers.

Development and progression, Muscular dystrophy

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