Report of methamphetamine use and cardiomyopathy in three patients

A 28-year old man and two women, ages 29 and 31-year-old, with a history of meth use, were admitted to the emergency department with severe dyspnea at rest. Each had sinus tachycardia with tachypnea and an echocardiogram that showed severe systolic dysfunction consistent with heart failure. Additional evaluation in the hospital revealed cardiomyopathy with no other etiology other than the meth use.There are several reports that show an increase in frequency of meth use, suggesting that cardiomyopathy and acute heart failure may be a new medical concern.Substance misuse is a major health problem in all parts of the world. Methamphetamine (meth) is a synthetic amine stimulant that is a highly addictive stimulant, and is currently the most widespread illegal amine drug used in the United States [1]. Its use has increased during the past two decades, especially in teenagers [2,3]. The last report by the Iranian drug control headquarters showed that only 3.6% of substance users in Iran used meth [4]. However, in recent years the local production of meth has risen and its price has decreased, resulting in growing use of the drug. Nonofficial reports estimate that meth is currently the second or third most widely used illicit substance in Iran [5].Chronic use results in a number of medical complications and fatalities [6]. Meth directly affects multiple organs, as well as causes hypertension and tachycardia, cardiovascular complications such as myocardial infarction, dysrhythmias, ventricular hypertrophy, pulmonary edema and hypertension, cerebral stroke and hemorrhage, seizures, psychosis, and occasionally death may occur [7]. Due to the combination of some of these effects, long term users may develop cardiomyopathy. Although the incidence of methamphetamine cardiomyopathy is unknown, we report three cases of methamphetamine cardiomyopathy in Iran.Three patients, a 28-year-old man, and a 29 and 31-year-old woman, were admitted separately in Loghman Hakim Hospital, a refe