Amphetamine Use Revealing Hypertrophic Cardiomyopathy in a Young Patient

Abstract

Adrenergic overstimulation in long term can lead to a hyperdynamic myocardium and give rise to hypertrophy and ultimately to heart failure. Amphetamine use is a common cause of neurohormonal activation, which gives rise to such adverse cardiovascular events. However, hypertrophy of myocardium in young patients, even due to apparently obvious causes, should always be considered as a red flag and a further diagnostic downstream should take place, in order to exclude genetic causes. We present a case of a young man with chronic use of amphetamine and an incidental finding of hypertrophic cardiomyopathy.

Keywords: Cardiac MRI; Hypertrophic cardiomyopathy; Myopericarditis; Sudden cardiac death.

Figure 1

CMRI long axis four-chamber view (a), and short axis view at the level of papillary muscles (b): asymmetric septal hypertrophy (as shown by short lines) is appreciated. Gadolinium-enhanced CMRI short axis view at the level of papillary muscles (c): late gadolinium enhancement on the right side and ventricular insertion points can be appreciated (as shown by arrows), typically indicating hypertrophic cardiomyopathy. CMRI: cardiac magnetic resonance imaging.