Ewha Med J.  2014 Dec;37(Suppl):S37-S40. 10.12771/emj.2014.37.S.S37.

Amphetamine-Like Weight Reduction Drug Induced Acute Cardiomyopathy with Left Ventricular Thrombosis

• Kim JM
• Ryu SK
• Choi JW
• Shin DG
• Lee YH
• Kang HR
• Chae WY
• Park JS

• KMID: 2171310
• DOI: http://doi.org/10.12771/emj.2014.37.S.S37

Abstract

A 37-year-old female patient admitted due to dyspnea on exertion and peripheral edema. For one and a half years, the patient had been taking various drugs and supplements to reduce weight, including amphetamine-like drugs. The patient had no major cardiovascular risk factors except three pack-years of smoking. A chest computed tomography showed a 1.7 cm diameter, capsulated space-occupying lesion in the left ventricle (LV) and 2-dimensional echocardiography showed LV systolic dysfunction (Left ventricular ejection fraction [LVEF], 30%) with a mobile cystic mass (1.1x1.8 cm) that was attached to the LV apex, which was increased in size and number the next day, even with low dose low-molecular-weight heparin. With an increased dose of anticoagulation medication and heart failure management with diuretics and angiotensin receptor II blocker, LV dysfunction was recovered and the LV thrombus disappeared.

Keyword

Amphetamine; Cardiomyopathies; Thrombosis

MeSH Terms

Adult
Amphetamine
Angiotensins
Cardiomyopathies*
Diuretics
Dyspnea
Echocardiography
Edema
Female
Heart Failure
Heart Ventricles
Heparin, Low-Molecular-Weight
Humans
Risk Factors
Smoke
Smoking
Stroke Volume
Thorax
Thrombosis*
Weight Loss*
Amphetamine
Angiotensins
Diuretics
Heparin, Low-Molecular-Weight
Smoke

Figure

• 

  Fig. 1 Initial chest X-ray showed cardiomegaly with pulmonary congestion.

• 

  Fig. 2 Chest computed tomography shows capsulated space occupying lesion with 1.7 cm in diameter in left ventricle (arrow).

• 

  Fig. 3 Two-dimensional echocardiography follow-up. (A) Initially mobile cystic mass (1.1×1.8 cm) is attached to septal area of apex of left ventricle and small mass like lesion was attached to papillary muscle (arrows). (B) Number and size of masses increased in one day (arrows). (C) Masses disappeared on discharge.

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