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

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.