Multiple Biventricular Thrombi Associated With Methamphetamine-Associated Cardiomyopathy
Syeda H Zaidi1, Umair A Khan2, Shazib Sagheer3
1Department of Internal Medicine, Karachi Medical and Dental College, Karachi, Sindh, Pakistan.
Methamphetamine use is linked to heart problems and an increased risk of blood clots. This case report highlights a rare association between methamphetamine-associated cardiomyopathy and biventricular thrombi, suggesting proactive screening for heart clots in affected patients.
Area of Science:
- Cardiology
- Toxicology
- Cardiovascular Imaging
Background:
- Global increase in methamphetamine use correlates with rising cardiovascular mortality.
- Methamphetamine-associated cardiomyopathy (MACM) is a serious cardiovascular complication.
- Limited data exists on the thrombogenicity risks associated with methamphetamine use.
Observation:
- A patient with MACM presented with acute decompensated heart failure and biventricular masses.
- Initial echocardiogram showed masses; patient left against medical advice on warfarin.
- Readmission revealed left ventricular thrombi and pulmonary embolism via CMR and CT.
Findings:
- The case demonstrates a rare association between MACM and biventricular thrombi.
- Pulmonary embolism was diagnosed, suggesting thrombus migration or resolution.
- Increased circulating catecholamines from methamphetamine use may drive thrombogenicity.
Implications:
- Early screening for intracardiac thrombi is crucial in MACM patients with active methamphetamine use.
- Surveillance echocardiography should be considered for even mild heart failure symptoms.
- Further research is needed to elucidate the mechanisms linking methamphetamine use, MACM, and thrombogenicity.
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