Fatal coronary artery intimal hyperplasia due to amphetamine use

Abstract Background Amphetamines have been reported to cause myocardial infarct, cerebral hemorrhage, aortic dissection, hypertension, vasculitis, aneurysms, and, occasionally, death from direct toxicity. To date, there have been no reports of coronary intimal hyperplasia in an amphetamine user. Met...

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Bibliographic Details
Published in:Cardiovascular pathology 2013-05, Vol.22 (3), p.e1-e4
Main Author: Cohle, Stephen D
Format: Article
Language:English
Subjects:
Adult
Amphetamine
Amphetamines - adverse effects
Atomoxetine Hydrochloride
Attention Deficit Disorder with Hyperactivity - drug therapy
Cocaine
Coronary Artery Disease - chemically induced
Coronary Artery Disease - pathology
Fatal Outcome
Humans
Hyperplasia
Intimal hyperplasia
Male
Methylphenidate - adverse effects
Myocardial infarct
Myocardial Infarction - chemically induced
Myocardial Infarction - pathology
Pathology
Propylamines - adverse effects
Sumatriptan
Tunica Intima - pathology
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Summary:Abstract Background Amphetamines have been reported to cause myocardial infarct, cerebral hemorrhage, aortic dissection, hypertension, vasculitis, aneurysms, and, occasionally, death from direct toxicity. To date, there have been no reports of coronary intimal hyperplasia in an amphetamine user. Methods A 29-year-old male was found collapsed after jogging. He had been taking amphetamines for 11 years for attention deficit/hyperactivity disorder. Past medical history was positive for mild hypertension and migraine headaches. He underwent a complete autopsy and drug screen. Results At gross autopsy his left anterior descending (LAD) coronary artery was occluded and he had an old myocardial infarct in the anterior wall of the left ventricle. Microscopic findings included occlusive intimal hyperplasia (positive for smooth muscle actin) in the LAD and an old left ventricular anterior wall infarct surrounded by acute infarct. Conclusion In addition to other reported adverse effects, amphetamines can also cause occlusive intimal hyperplasia of the coronary arteries.
ISSN:1054-8807
1879-1336
DOI:10.1016/j.carpath.2012.07.007