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Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
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Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
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Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Related Experiment Video

Updated: Sep 13, 2025

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Kratom-Associated Acute Right Ventricular Dysfunction: Diagnostic and Management Insights.

Ibrahim Alameh1, Maria V Lebedev2, John M Clark3

  • 1Department of Internal Medicine, Lankenau Medical Center, Wynnewood, Pennsylvania, USA.

JACC. Case Reports
|July 25, 2025
PubMed
Summary

Kratom (Mitragyna speciosa) use may cause acute right ventricular (RV) dysfunction, even with intermittent use. Prompt assessment is key for recovery from this cardiovascular toxicity.

Keywords:
acute heart failurecardiomypathyright ventriclesystolic heart failure

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Area of Science:

  • Cardiology
  • Toxicology

Background:

  • Kratom (Mitragyna speciosa) is a psychoactive herbal supplement with stimulant and opioid-like properties.
  • Emerging reports suggest Kratom use is linked to cardiovascular toxicity.
  • Its specific impact on right ventricular (RV) function is not well understood.

Observation:

  • A 52-year-old man presented with shock, hypoxia, and multiorgan dysfunction.
  • Echocardiography showed severe RV dilation with McConnell's sign.
  • Right heart catheterization revealed elevated right-sided pressures and high cardiac output.

Findings:

  • The patient was diagnosed with high-output RV failure.
  • Other potential causes like thyrotoxicosis, arteriovenous fistula, liver disease, thiamine deficiency, and infection were excluded.
  • RV function improved with supportive management and inotropic therapy.

Implications:

  • This case highlights Kratom as a potential cause of unexplained acute RV dysfunction.
  • Recognizing Kratom's role is crucial for diagnosing and managing such cases.
  • Echocardiographic and hemodynamic assessments are vital for effective treatment strategies.