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Case Reports
. 2023 Apr 1;2(2):73233.
doi: 10.56305/001c.73233. eCollection 2023.

Transient Right Ventricular Failure from Intravenous Injection of Methylphenidate Tablets

Arjun Chatterjee  1 , Alejandro Duran Crane  2 , Caroline Olt  1 , Marina Freiberg  3
Affiliations
Case Reports

Transient Right Ventricular Failure from Intravenous Injection of Methylphenidate Tablets

Arjun Chatterjee et al. Brown J Hosp Med. .

Abstract

Methylphenidate (MPH) is a sympathomimetic stimulant used to manage adult narcolepsy and attention deficit hyperactivity disorder (ADHD), which is frequently abused. We present the case of a 37-year-old female who developed acute right ventricle (RV) failure after the self-injection of IV MPH. While difficult to prove causation, the temporal relationship between self-injection and symptom onset suggests a role for MPH in this patient's acute RV failure. Other causes for acute RV failure were ruled out: she had no prior history of PH, ECG was not consistent with ischemia, computed tomography angiography (CTA) was negative for pulmonary embolism (PE), and Right heart catheterization (RHC) was not consistent with left ventricular failure. While there are case reports of persistent PH with chronic IV MPH use, this case describes the only reported incident of transient acute RV failure after IV MPH use.

Keywords: ECHO; IV drug use; POCUS; RV failure; methylphenidate.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.. Four chamber view echocardiogram showing right ventricle (RV) dilation with bowing of the interventricular septum leading to left ventricle (LV) underfilling.
See this image and copyright information in PMC

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