Related Experiment Video
Updated: Jan 8, 2026

Acetylcholine Re-Challenge After Intracoronary Nitroglycerine Administration
Published on: April 4, 2022
Methamphetamine-Induced Coronary Vasospasm and Recurrent Cardiac Arrest: A Quick Glance May Not Be Good Enough
Ramtin Khanipour1, Kevin Velasquez1, Wesley Navaez1
1Division of Cardiology, HCA Healthcare-HCA Florida Bayonet Point/USF Morsani College of Medicine, Hudson, Florida, USA.
Background:
Methamphetamine can cause coronary vasospasm and atherosclerotic plaque disruption, leading to myocardial ischemia and tachyarrhythmias.
Case Summary:
A 51-year-old man experienced recurrent episodes of polymorphic ventricular tachycardia (PMVT) and cardiac arrest after using methamphetamine. Initial coronary angiography (CA) revealed diffuse multivessel coronary artery disease; therefore, percutaneous coronary intervention was deferred. On day 12 of hospitalization, he developed acute anterior ST-segment elevation myocardial infarction complicated by PMVT and cardiac arrest. Repeat CA revealed only a single focal culprit lesion in the mid-left anterior descending artery. This was simply treated with a single drug-eluting stent.
Discussion:
Coronary vasospasm can make detection of culprit lesions on CA alone difficult. Reassessment after administration of vasodilators should be considered.
Take-Home Messages:
Methamphetamine can induce severe coronary vasospasm, endothelial dysfunction, and atherosclerotic plaque disruption. Vasodilators should be considered during coronary angiography before determining next steps in management.
Related Concept Videos
Cardiopulmonary Resuscitation IV: Pharmacological Management
Coronary Artery Disease III: Clinical Manifestations
Acute Coronary Syndrome IV: Interprofessional Care
Acute Coronary Syndrome I: Introduction
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
Myocarditis III: Medical Management

