Death following recreational use of designer drug "bath salts" containing 3,4-Methylenedioxypyrovalerone (MDPV)

Abstract

Introduction: 3,4-Methylenedioxypyrovalerone (MDPV) is a designer stimulant drug that has gained popularity in the USA. Although adverse effects of MDPV have been described, to our knowledge, this is the first reported death.

Case report: We report the case of a 40-year-old male who injected and snorted "bath salts" containing MDPV and subsequently became agitated, aggressive, and experienced a cardiac arrest. He was resuscitated after his initial arrest; however, he developed hyperthermia, rhabdomyolysis, coagulopathy, acidosis, anoxic brain injury, and subsequently died.

Discussion: This is the first case in the medical literature to report death due to isolated confirmed MDPV intoxication. The manner of death is also consistent with excited delirium syndrome.

Fig. 1

Chemical structures of 3,4-methylenedioxypyrovalerone (MDPV); cathinone; 3,4-methylenedioxymethamphetamine (MDMA); and pyrovalerone

Fig. 2

a Initial prehospital EKG. b Repeat prehospital EKG performed 10 min later demonstrating normal sinus rhythm with rate of 85 bpm, PR interval 110 msec, QRS interval 116 msec, QTc interval 414 msec, and peaked T waves

Fig. 3

Post-arrest EKG

Fig. 4

EKG after treatment for hyperkalemia. PR interval of 125 msec, QRS interval of 83 msec, QTc interval of 412 msec, normalization of the T waves and ST depressions in leads II and III with mild ST elevation in leads V1 and V2