Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Jun;31(6):939-945.
doi: 10.1007/s00787-021-01729-2. Epub 2021 Feb 3.

Acute myocardial infarction due to spontaneous coronary artery dissection in a 6-year-old boy with ADHD on the third day of treatment with methylphenidate

Affiliations
Case Reports

Acute myocardial infarction due to spontaneous coronary artery dissection in a 6-year-old boy with ADHD on the third day of treatment with methylphenidate

Thomas Stammschulte et al. Eur Child Adolesc Psychiatry. 2022 Jun.

Abstract

Methylphenidate (MPH) is an indirect-acting sympathomimetic drug and structurally related to amphetamine. It is widely used to treat children aged 6 years and older, as well as adolescents who have attention-deficit/hyperactivity disorder (ADHD). We report on a 6-year-old boy who presented with typical angina symptoms occurring several hours after intake of an increased dose of MPH, which had been initiated for ADHD treatment 2 days earlier. Despite typical angina symptoms, the diagnosis of myocardial infarction due to spontaneous coronary artery dissection of the right coronary artery was delayed. Most epidemiological studies could not detect an increased risk for cardiovascular events in association with ADHD medications. However, the direct temporal relationship in our case indicates the possibility that MPH may trigger spontaneous coronary artery dissection in predisposed patients. Since myocardial infarction in children is rare but comprises various etiologies, awareness of this possible catastrophic event among medical staff may be lower and may delay immediate life-saving diagnostic and therapeutic measures.

Keywords: Adverse drug reaction; Attention deficit hyperactivity disorder; Methylphenidate; Myocardial infarction; Spontaneous coronary artery dissection.

PubMed Disclaimer

References

    1. EMA (2009) Questions and answers on the review of medicines containing methylphenidate. https://www.ema.europa.eu/en/documents/referral/questions-answers-review... . Accessed: 6 Jan 2020. Doc. Ref. EMEA/658285/2008; London, 22 Jan
    1. Arzneiverordnungs-Report 2019 (2019) Springer-Verlag, Berlin
    1. Faraone SV (2018) The pharmacology of amphetamine and methylphenidate: relevance to the neurobiology of attention-deficit/hyperactivity disorder and other psychiatric comorbidities. Neurosci Biobehav Rev 87:255–270. https://doi.org/10.1016/j.neubiorev.2018.02.001 - DOI - PubMed - PMC
    1. Novartis Pharma GmbH (2019) Fachinformation “Ritalin® 10 mg Tabletten”. Stand: Oktober
    1. Daly MW, Custer G, McLeay PD (2008) Cardiac arrest with pulseless electrical activity associated with methylphenidate in an adolescent with a normal baseline echocardiogram. Pharmacotherapy 28(11):1408–1412. https://doi.org/10.1592/phco.28.11.1408 - DOI - PubMed

Publication types

MeSH terms

Substances

LinkOut - more resources