Frequency of acute coronary syndrome in patients presenting to the Emergency Department with chest pain after methamphetamine use

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Abstract

We reviewed the frequency of acute coronary syndrome (ACS) in patients presenting to our Emergency Department (ED) with chest pain after methamphetamine (MAP) use during a 2-year interval. Thirty-three patients (25 males, 8 females; average age 40.4 ± 8.0 years) with a total of 36 visits met study inclusion criteria: 1) non-traumatic chest pain, 2) positive MAP urine toxicology screen, 3) admission to "rule-out" myocardial infarction, 4) chest radiograph demonstrating no infiltrates. An ACS was diagnosed in 9 patients (25%). Three patients (8%) (2 ACS and 1 non-ACS) suffered cardiac complications (ventricular fibrillation, ventricular tachycardia, supraventricular tachycardia, respectively). Age, gender, cardiac risk factors, prior coronary artery disease, initial systolic blood pressure and heart rate did not differ significantly in the ACS and non-ACS groups. The initial and subsequent electrocardiograms (EKG) were normal in 1/9 (11%) patients with ACS and 16/27 (59%) without ACS (p < 0.05). Our findings suggest that: 1) ACS is common in patients hospitalized for chest pain after MAP use, and 2) the frequency of other potentially life-threatening cardiac complications is not negligible. A normal EKG lowers the likelihood of ACS, but an abnormal EKG is not helpful in distinguishing patients with or without ACS.

Original languageEnglish (US)
Pages (from-to)369-373
Number of pages5
JournalJournal of Emergency Medicine
Volume24
Issue number4
DOIs
StatePublished - May 2003

Fingerprint

Methamphetamine
Acute Coronary Syndrome
Chest Pain
Hospital Emergency Service
Electrocardiography
Blood Pressure
Supraventricular Tachycardia
Ventricular Fibrillation
Ventricular Tachycardia
Toxicology
Coronary Artery Disease
Thorax
Heart Rate
Myocardial Infarction
Urine

Keywords

  • Acute coronary syndrome
  • Chest pain
  • Emergency department
  • Methamphetamine

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

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title = "Frequency of acute coronary syndrome in patients presenting to the Emergency Department with chest pain after methamphetamine use",
abstract = "We reviewed the frequency of acute coronary syndrome (ACS) in patients presenting to our Emergency Department (ED) with chest pain after methamphetamine (MAP) use during a 2-year interval. Thirty-three patients (25 males, 8 females; average age 40.4 ± 8.0 years) with a total of 36 visits met study inclusion criteria: 1) non-traumatic chest pain, 2) positive MAP urine toxicology screen, 3) admission to {"}rule-out{"} myocardial infarction, 4) chest radiograph demonstrating no infiltrates. An ACS was diagnosed in 9 patients (25{\%}). Three patients (8{\%}) (2 ACS and 1 non-ACS) suffered cardiac complications (ventricular fibrillation, ventricular tachycardia, supraventricular tachycardia, respectively). Age, gender, cardiac risk factors, prior coronary artery disease, initial systolic blood pressure and heart rate did not differ significantly in the ACS and non-ACS groups. The initial and subsequent electrocardiograms (EKG) were normal in 1/9 (11{\%}) patients with ACS and 16/27 (59{\%}) without ACS (p < 0.05). Our findings suggest that: 1) ACS is common in patients hospitalized for chest pain after MAP use, and 2) the frequency of other potentially life-threatening cardiac complications is not negligible. A normal EKG lowers the likelihood of ACS, but an abnormal EKG is not helpful in distinguishing patients with or without ACS.",
keywords = "Acute coronary syndrome, Chest pain, Emergency department, Methamphetamine",
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