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Methamphetamine-Induced Coronary Vasospasm and Recurrent Cardiac Arrest

Year: 2025

Type: article

Abstract: BACKGROUND: Methamphetamine can cause coronary vasospasm and atherosclerotic plaque disruption, leading to myocardial ischemia and tachyarrhythmias. CASE SUMMARY: A 51-year-old man experienced recurrent episodes of polymorphic ventricular tachycardia (PMVT) and cardiac arrest after using methamphetamine. Initial coronary angiography (CA) revealed diffuse multivessel coronary artery disease; therefore, percutaneous coronary intervention was deferred. On day 12 of hospitalization, he developed acute anterior ST-segment elevation myocardial infarction complicated by PMVT and cardiac arrest. Repeat CA revealed only a single focal culprit lesion in the mid-left anterior descending artery. This was simply treated with a single drug-eluting stent. DISCUSSION: Coronary vasospasm can make detection of culprit lesions on CA alone difficult. Reassessment after administration of vasodilators should be considered. TAKE-HOME MESSAGES: Methamphetamine can induce severe coronary vasospasm, endothelial dysfunction, and atherosclerotic plaque disruption. Vasodilators should be considered during coronary angiography before determining next steps in management.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.105835

Authors: Ramtin Khanipour, Kevin Velasquez, Wesley Navaez, Mohammad Ahmad, Ali Dahhan

Institutions: University of South Florida, HCA Healthcare

Language: English

Topic: Coronary Interventions and Diagnostics

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850