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A woman experienced acute right ventricle failure after injecting methylphenidate (MPH). This case highlights a potential link between MPH misuse and sudden heart problems, distinct from chronic effects.

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Area of Science:

  • Cardiology
  • Pharmacology
  • Toxicology

Background:

  • Methylphenidate (MPH) is a stimulant prescribed for ADHD and narcolepsy.
  • MPH is also frequently abused, particularly via intravenous (IV) administration.
  • Understanding the cardiovascular risks associated with MPH misuse is critical.

Observation:

  • A 37-year-old female presented with acute right ventricle (RV) failure.
  • Symptoms developed shortly after self-injection of IV methylphenidate.
  • The patient had no prior history of pulmonary hypertension or cardiac issues.

Findings:

  • Diagnostic workup, including ECG, CTA, and RHC, excluded other common causes of RV failure such as ischemia, pulmonary embolism, and left ventricular failure.
  • The temporal association strongly suggests methylphenidate as a potential cause of acute RV failure.
  • This is the first reported case of transient acute RV failure linked to IV MPH use.

Implications:

  • This case suggests a potential for acute cardiovascular toxicity from IV methylphenidate, even in individuals without pre-existing conditions.
  • It underscores the importance of considering stimulant misuse in patients presenting with unexplained acute heart failure.
  • Further research may be needed to elucidate the mechanisms behind MPH-induced acute RV dysfunction.