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Here, we describe the case of a 45-year-old woman who died of cardiovascular collapse while taking ephedra. Tissue analysis revealed non-specific degenerative alterations in the myocardium (lipofuscin accumulation, basophilic degeneration and vacuolation of myocytes, as well as myofibrillary loss), associated with myocyte apoptosis, caspase activation, and extensive cleavage of miofibrillary proteins \u03b1-actin, \u03b1-actinin, and cardiac troponin T. Healthcare professionals are therefore urged to warn their patients about the risk of serious adverse effects, which may follow ephedra intake.<\/jats:p>","DOI":"10.1016\/j.ejheart.2004.09.012","type":"journal-article","created":{"date-parts":[[2005,7,29]],"date-time":"2005-07-29T12:49:28Z","timestamp":1122641368000},"page":"927-930","source":"Crossref","is-referenced-by-count":11,"title":["A Case of Fatal Ephedra Intake Associated with Lipofuscin Accumulation, Caspase Activation and Cleavage of Myofibrillary Proteins"],"prefix":"10.1093","volume":"7","author":[{"given":"Carol","family":"Chen-Scarabelli","sequence":"first","affiliation":[{"name":"Division of Cardiology, VA Medical Center, University of Michigan , Ann Arbor, MI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si\u00e2n E.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Royal Free and University College Medical School, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgio","family":"Landon","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Royal Free and University College Medical School, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rowley","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Royal Free and University College Medical School, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuhair","family":"Allebban","sequence":"additional","affiliation":[{"name":"Divisions of and Cardiology, St John Hospital, Wayne State University , Detroit, MI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel","family":"Lawson","sequence":"additional","affiliation":[{"name":"Divisions of Pathology, St John Hospital, Wayne State University , Detroit, MI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Saravolatz","sequence":"additional","affiliation":[{"name":"Divisions of Internal Medicine, St John Hospital, Wayne State University , Detroit, MI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius","family":"Gardin","sequence":"additional","affiliation":[{"name":"Divisions of and Cardiology, St John Hospital, Wayne State University , Detroit, MI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Latchman","sequence":"additional","affiliation":[{"name":"Institute of Child Health, University College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziano M.","family":"Scarabelli","sequence":"additional","affiliation":[{"name":"Divisions of and Cardiology, St John Hospital, Wayne State University , Detroit, MI ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2005,8,7]]},"reference":[{"key":"2026020203555977200_ejhf2004-09-012-bib-0001","first-page":"5","article-title":"Ephedra\/ephedrine: cardiovascular and CNS effects","volume":"166","author":"Wooltorton","year":"2002","journal-title":"CMAJ"},{"key":"2026020203555977200_ejhf2004-09-012-bib-0002","doi-asserted-by":"crossref","first-page":"468","DOI":"10.7326\/0003-4819-138-6-200303180-00010","article-title":"The relative safety of ephedra compared with other herbal products","volume":"138","author":"Bent","year":"2003","journal-title":"Ann. 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