{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:36:23Z","timestamp":1767706583879,"version":"3.41.2"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T00:00:00Z","timestamp":1644364800000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Amphetamine use causes cardiomyopathy via catecholamine-mediated effects such as tachycardia, hypertension, vasoconstriction, and direct cardio-toxic effects. Traditionally, an increased risk of haemorrhagic stroke is associated with amphetamine use. However, up to one-third of stimulant-associated cardiomyopathy patients have left ventricular (LV) thrombus formation leading to an increased risk of systemic embolization. We report a case of amphetamine-induced cardiomyopathy complicated by embolic stroke secondary to LV thrombus.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 38-year-old man with 6-month history of sustained amphetamine use presented to the emergency department with left-sided weakness, facial droop, and dysarthria. Angiography confirmed right middle cerebral artery thrombus. Prompt mechanical thrombectomy yielded full neurological recovery. Dyspnoea prompted transthoracic echocardiography showing dilated cardiomyopathy with an ejection fraction of 5% and LV thrombus. Anticoagulation was initiated with warfarin as well as pharmacological therapy for heart failure with reduced ejection fraction including bisoprolol, spironolactone, loop diuretic, and sacubitril\/valsartan. He was discharged successfully following resolution of ventricular thrombus and medical management of heart failure. Clinical recovery was hampered by psychosocial factors resulting in non-adherence to medical therapy and continued amphetamine use.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Sustained amphetamine use can result in severe dilated cardiomyopathy with LV thrombus formation and embolic complications such as ischaemic stroke. Avoidance of amphetamines in conjunction with guideline-directed pharmacological management are key components of therapy. However, psychosocial factors can exert significant influence on recovery.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac044","type":"journal-article","created":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T17:56:12Z","timestamp":1644429372000},"source":"Crossref","is-referenced-by-count":8,"title":["Amphetamine-induced cardiomyopathy complicated by embolic stroke: a case report"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2358-9562","authenticated-orcid":false,"given":"Lucy","family":"Chapman","sequence":"first","affiliation":[{"name":"South Tipperary General Hospital, Clonmel, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ismail","family":"Tahir","sequence":"additional","affiliation":[{"name":"South Tipperary General Hospital, Clonmel, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neha","family":"Sheriff","sequence":"additional","affiliation":[{"name":"South Tipperary General Hospital, Clonmel, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niall","family":"Colwell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,2,9]]},"reference":[{"author":"European Monitoring Centre for Drugs and Drug Addiction","key":"2022041316574744800_ytac044-B1"},{"key":"2022041316574744800_ytac044-B2","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1111\/j.1360-0443.2007.01874.x","article-title":"Methamphetamine and cardiovascular pathology: a review of the evidence","volume":"102","author":"Kaye","year":"2007","journal-title":"Addiction"},{"key":"2022041316574744800_ytac044-B3","doi-asserted-by":"crossref","first-page":"1739","DOI":"10.1161\/ATVBAHA.119.312461","article-title":"Methamphetamine use and cardiovascular disease","volume":"39","author":"Kevil","year":"2019","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"2022041316574744800_ytac044-B4","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/j.jchf.2017.02.017","article-title":"Clinical characteristics, histopathological features, and clinical outcome of methamphetamine-associated cardiomyopathy","volume":"5","author":"Sch\u00fcrer","year":"2017","journal-title":"JACC Heart Fail"},{"key":"2022041316574744800_ytac044-B5","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1136\/jnnp-2017-316071","article-title":"Stroke and methamphetamine use in young adults: a review","volume":"88","author":"Lappin","year":"2017","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"2022041316574744800_ytac044-B6","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/j.hlc.2016.11.005","article-title":"Is an abnormal ECG just the tip of the ICE-berg? Examining the utility of electrocardiography in detecting methamphetamine-induced cardiac pathology","volume":"26","author":"Paratz","year":"2017","journal-title":"Heart Lung Circ"},{"key":"2022041316574744800_ytac044-B7","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/j.hlc.2016.03.008","article-title":"Clinical characteristics and outcomes of patients with amphetamine-associated cardiomyopathy in South Auckland, New Zealand","volume":"25","author":"Kueh","year":"2016","journal-title":"Heart Lung Circ"},{"key":"2022041316574744800_ytac044-B8","doi-asserted-by":"crossref","first-page":"1332","DOI":"10.1002\/med.21476","article-title":"Comprehensive review of cardiovascular toxicity of drugs and related agents","volume":"38","author":"Mlad\u011bnka","year":"2018","journal-title":"Med Res Rev"},{"key":"2022041316574744800_ytac044-B9","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.jacc.2010.02.047","article-title":"Assessment of nonischemic myocardial fibrosis","volume":"56","author":"Jellis","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2022041316574744800_ytac044-B10","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1016\/j.ajem.2018.01.001","article-title":"Methamphetamine use and heart failure: prevalence, risk factors, and predictors","volume":"36","author":"Richards","year":"2018","journal-title":"Am J Emerg Med"},{"key":"2022041316574744800_ytac044-B11","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1111\/j.1365-2125.2004.02176.x","article-title":"Ally McBeal heart?\u2019\u2014drug induced cardiomyopathy in a young woman","volume":"58","author":"Crean","year":"2004","journal-title":"Br J Clin Pharmacol"},{"key":"2022041316574744800_ytac044-B12","first-page":"e9","article-title":"Methamphetamine-induced cardiomyopathy (MACM) in a middle-aged man; a case report","volume":"2018","author":"Qutrio Baloch","year":"2018","journal-title":"Emerg (Tehran)"},{"key":"2022041316574744800_ytac044-B13","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1097\/FJC.0000000000000826","article-title":"Direct oral anticoagulants for the treatment of left ventricular thrombus\u2014a new indication? A meta-summary of case reports","volume":"75","author":"Tomasoni","year":"2020","journal-title":"J Cardiovasc Pharmacol"},{"key":"2022041316574744800_ytac044-B14","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1177\/1753944717711139","article-title":"Challenges in management of left ventricular thrombus","volume":"11","author":"Habash","year":"2017","journal-title":"Ther Adv Cardiovasc Dis"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytac044\/42447094\/ytac044.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/2\/ytac044\/43375564\/ytac044.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/6\/2\/ytac044\/43375564\/ytac044.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,13]],"date-time":"2022-04-13T17:00:06Z","timestamp":1649869206000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytac044\/6525222"}},"subtitle":[],"editor":[{"given":"Elizabeth","family":"Paratz","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Nikos","family":"Papageorgiou","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Lucrecia Maria","family":"Burgos","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Lavanya","family":"Athithan","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]},{"given":"Gon\u00e7alo","family":"Costa","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,2,1]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022,2,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytac044","relation":{},"ISSN":["2514-2119"],"issn-type":[{"type":"electronic","value":"2514-2119"}],"subject":[],"published-other":{"date-parts":[[2022,2,1]]},"published":{"date-parts":[[2022,2,1]]},"article-number":"ytac044"}}