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. 2016 Dec;3(1):10.
doi: 10.1007/s40800-016-0035-7.

STEMI Secondary to Coronary Vasospasm: Possible Adverse Event of Methylphenidate in a 21-Year-Old Man with ADHD

Timo-Benjamin Baumeister  1 , Ingo Wickenbrock  2 , Christian A Perings  2
Affiliations

STEMI Secondary to Coronary Vasospasm: Possible Adverse Event of Methylphenidate in a 21-Year-Old Man with ADHD

Timo-Benjamin Baumeister et al. Drug Saf Case Rep. 2016 Dec.

Abstract

Methylphenidate (Ritalin®) is an increasingly used medication in the treatment of attention-deficit hyperactivity disorder (ADHD). Cardiovascular adverse effects like vasospasm or myocardial infarction are described as very rare adverse effects. We present the case of a 21-year-old man diagnosed with ADHD who recently started therapy with Ritalin® Adult 20 mg for at least 3 days. Afterwards he presented with chest pain, elevated troponin and creatine kinase, and posterolateral ST elevations. A myocarditis was initially supposed. In the coronary angiography, signs of coronary artery spasm could be found. The echocardiography showed mild left ventricular dysfunction; no acute myocarditis could be found in the cardiac MRI and myocardial biopsy. The medication with methylphenidate was stopped, and after 12 days the asymptomatic patient was discharged from hospital.

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Conflict of interest statement

Timo-Benjamin Baumeister, Ingo Wickenbrock and Christian Perings declare that they have no conflicts of interest. Consent Written informed consent was obtained from the patient for publication of this case report. A copy of the written consent is available for review by the corresponding author of this article. Study funding statement No financial support was received for the preparation of this manuscript.

Figures

Fig. 1
Fig. 1
Electrocardiography day 1; ST elevations II, III, aVF, V4–6; 50 mm/s, 10 mm/mV; GE MAC 2000
Fig. 2
Fig. 2
Coronary angiography; coronary vasospasm proximal right coronary artery
Fig. 3
Fig. 3
Electrocardiography day 2; T-negativity III, aVF, V3–5; 50 mm/s, 10 mm/mV; GE MAC 1200
See this image and copyright information in PMC

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