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Spontaneous pneumomediastinum and myocarditis following Ecstasy use: a case report

Luc J M Mortelmans1, Peter J M Bogaerts, Steven Hellemans

  • 1Departments of Emergency Medicine, AZ Klina, Brasschaat, Belgium. luc.mortelmans@klina.be

European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine
|January 28, 2005
PubMed

Insights

This case report details a 16-year-old boy who developed spontaneous pneumomediastinum and myocarditis after Ecstasy use. This rare combination highlights potential cardiac and thoracic risks associated with party drugs.

Area of Science:

  • Toxicology
  • Cardiology
  • Emergency Medicine

Background:

  • Ecstasy (3,4-methylenedioxymethamphetamine) is a widely used recreational drug known for various health complications.
  • Spontaneous pneumomediastinum (SPM) is typically associated with inhalation drug use and Valsalva maneuvers, but is rarely reported after oral party drug ingestion.

Observation:

  • A 16-year-old male presented to the Emergency Department following Ecstasy ingestion.
  • The patient developed spontaneous pneumomediastinum (SPM) and myocarditis, a combination not previously documented.

Findings:

  • Prolonged and excessive dancing, a common behavior in party drug culture, is hypothesized as the causative event for SPM in this case.
  • Ecstasy, like cocaine, can precipitate cardiac complications, including myocarditis.

Implications:

  • Emergency physicians should consider SPM in drug users presenting with symptoms like neck emphysema, dysphagia, or chest pain.
  • This case underscores the potential for severe thoracic and cardiac complications following recreational Ecstasy use, even from ingestion.

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