TY - JOUR
T1 - Frequency of acute coronary syndrome in patients presenting to the Emergency Department with chest pain after methamphetamine use
AU - Turnipseed, Samuel D.
AU - Richards, John R.
AU - Kirk, J. Douglas
AU - Diercks, Deborah B.
AU - Amsterdam, Ezra A.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2003/5
Y1 - 2003/5
N2 - 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.
AB - 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.
KW - Acute coronary syndrome
KW - Chest pain
KW - Emergency department
KW - Methamphetamine
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U2 - 10.1016/S0736-4679(03)00031-3
DO - 10.1016/S0736-4679(03)00031-3
M3 - Article
C2 - 12745036
AN - SCOPUS:0037689358
SN - 0736-4679
VL - 24
SP - 369
EP - 373
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
IS - 4
ER -