Point-of-care Ultrasound for Detecting Methamphetamine-associated Heart Failure in the Emergency Department

Area of Science:

• Cardiology
• Emergency Medicine
• Toxicology

Background:

• Methamphetamine use is linked to heart failure with reduced ejection fraction, a condition often missed in emergency departments.
• Point-of-care ultrasound (POCUS) provides rapid, non-invasive cardiac assessment for high-risk individuals.

Purpose of the Study:

• To evaluate the diagnostic utility of POCUS in identifying methamphetamine-associated heart failure with reduced ejection fraction (HFrEF) in emergency department patients.
• To assess the correlation between methamphetamine use duration/frequency and cardiac abnormalities detected by POCUS.

Main Methods:

• A prospective cohort study was conducted in an urban Level I trauma center emergency department.
• Physician-performed cardiac POCUS assessed left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter in methamphetamine users and a control group.
• Diagnostic yield was calculated as the proportion of POCUS exams revealing abnormalities (LVEF < 40% or abnormal sex-specific LV end-diastolic diameter).

Main Results:

• Among 84 methamphetamine users, POCUS identified reduced LVEF in 31.4% and any sex-specific left ventricular end-diastolic diameter abnormality in 35.7%.
• Severe left ventricular end-diastolic diameter abnormalities were found in 17.9% of methamphetamine users, significantly higher than controls (5.8%).
• Increased duration and frequency of methamphetamine use were significantly associated with reduced LVEF.

Conclusions:

• Cardiac POCUS shows significant diagnostic yield for detecting methamphetamine-associated HFrEF in the emergency department setting.
• POCUS can facilitate early detection and management of methamphetamine-associated cardiac dysfunction, potentially preventing disease progression.