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"Bath salts" induced severe reversible cardiomyopathy.

Kamesh Sivagnanam1, Dhara Chaudari, Pablo Lopez

  • 1Department of Internal Medicine, East Tennessee State University, Johnson City, TN, U.S.A.

The American Journal of Case Reports
|August 7, 2013
PubMed
Summary

Synthetic cathinones, known as "bath salts," can cause severe, reversible dilated cardiomyopathy. This case highlights the potential cardiotoxic effects of mephedrone and Methylenedioxypyrovalerone (MDPV) abuse.

Keywords:
3,4-methylenedioxypyrovaleronedilated cardiomyopathymephedrone

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Area of Science:

  • Cardiology
  • Toxicology
  • Emergency Medicine

Background:

  • "Bath salts" are synthetic cathinones with stimulant properties, increasingly associated with systemic toxicity.
  • Abuse of these substances can lead to significant cardiovascular complications.

Purpose of the Study:

  • To present a case of unusual clinical course related to bath salt abuse.
  • To highlight the potential for severe, reversible dilated cardiomyopathy induced by synthetic cathinones.

Main Methods:

  • A 27-year-old male presented with agitation after using mephedrone/Methylenedioxypyrovalerone (MDPV) bath salts.
  • Diagnostic workup included laboratory tests, EKG, echocardiogram, and left heart catheterization.
  • Cardiomyopathy was diagnosed, and the patient was followed for 20 weeks after cessation of bath salt use.

Main Results:

  • The patient presented with tachycardia, hypotension, and fever.
  • Initial echocardiogram revealed dilated cardiomyopathy with a significantly reduced ejection fraction (15-20%).
  • After 20 weeks of abstinence, the patient was asymptomatic with a normalized ejection fraction (52%).

Conclusions:

  • Synthetic cathinones like MDPV and mephedrone possess cardiotoxic potential, causing cardiovascular manifestations such as dilated cardiomyopathy.
  • Reversible dilated cardiomyopathy is a significant risk associated with "bath salts" abuse.
  • Other causes of cardiomyopathy must be excluded to establish a diagnosis of bath salt-induced cardiomyopathy.