Methamphetamine-Associated Cardiomyopathy with Heart Failure

Typical patient:

(1) male

(2) White

(3) tachycardia

(4) tachypnea

(5) relatively young for heart failure

Comorbid conditions:

(1) obesity

(2) renal dysfunction with elevated serum creatinine

(3) former smoker

Laboratory findings:

(1) elevated serum BNP

(2) variable elevation of serum troponin

Echocardiography shows:

(1) moderate to severe left ventricular dysfunction, often  with LVEF < 30%

(2) right ventricular dysfunction

(3) abnormal ventricular wall motion

(4) higher pulmonary arterial pressures

Complications:

(1) stroke

The diagnosis requires exclusion of other explanations for cardiomyopathy.

Discontinuation of substance abuse is associated with improvement of cardiac function.