A new designer drug: Methylone related death

2012 ◽  
Vol 153 (7) ◽  
pp. 271-276 ◽  
Author(s):  
Katalin Kovács ◽  
Anita Réka Tóth ◽  
Éva Margit Kereszty
Keyword(s):  
Sudden Cardiac Death ◽  
Bronchial Asthma ◽  
Heart Muscle ◽  
Cardiac Death ◽  
Illicit Drugs ◽  
Fatal Case ◽  
Previous History ◽  
Designer Drugs ◽  
Gas Chromatography Mass Spectrometry ◽  
Designer Drug

This report presents a fatal case related to the consumption of methylone, a relatively new cathinone type designer drug. A 16-year-old boy suddenly lost his consciousness in a party. Resuscitation had been continued for about 1.5 hours at the intensive care unit, but it was unsuccessful. His previous history included cardiac malformation detected at infancy and bronchial asthma had been diagnosed one year before his death. Signs of sudden cardiac death were observed during autopsy. Methylone intake was proved in blood and liver extract using gas chromatography/mass spectrometry; its concentration was 272 ng/ml in the blood, and 387 ng/g in the liver. Pathohistology revealed microvascular steatosis in the liver, which raised the possibility of chronic use of toxic substances. In addition, striated heart muscle damage was observed, which could be due to the use of an amphetamine-like substance. The authors presume that steatosis of the heart muscle, congenital heart disease and bronchial asthma could be predisposing factors for sudden cardiac death that occurred in the presence of relatively low levels of methylone. Access to various designer drugs is easy, fast and broad. Consequently, the potential abuse or overdose should be taken into consideration in the emergency practice. The use of “non-illicit” drugs does not require formal intervention by the authorities, but the medical service must alarm the stakeholders. Orv. Hetil., 2012, 153, 271–276.

scholarly journals Long term prognosis of out-of-hospital cardiac arrest due to idiopathic ventricular fibrillation - a tertiary center experience

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
R Alves Pinto ◽  
T Proenca ◽  
M Martins Carvalho ◽  
PD Grilo ◽  
CX Resende ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Ventricular Fibrillation ◽  
Clinical Outcomes ◽  
Cardiac Death ◽  
Previous History ◽  
Provocative Test ◽  
Tertiary Center ◽  
History Of

Abstract Funding Acknowledgements Type of funding sources: None. Background  Sudden cardiac death (SCD) is an uncommon event in the absence of structural heart disease. However, ventricular fibrillation (VF) may occur in patients with unknown cardiac disease and a comprehensive work-up is needed to further improve diagnostic. Still, a significant and heterogenous group of patients remains labelled of Idiopathic VF and limited data is available regarding their natural history. Purpose The aim of this study was to evaluate the clinical outcomes of survivors of an aborted sudden cardiac death due to idiopathic VF or pulseless ventricular tachycardia (VT) and to assess possible predictors of recurrence. Methods  Patients who survived an idiopathic VF or pulseless VT between 2005 and 2019 referred to a cardiac defibrillator (ICD) implantation were included. Patients were followed for 1 to 15 years (median follow-up of 7 years). Clinical and device data were collected. Results A population of 29 patients, 59% male, with a median age of 50 years (age ranging from 18 to 76) at the time of the aborted SCD was studied. All patients implanted an ICD (69% single chamber, 24% dual chamber and 3% subcutaneous) at the index hospitalization. The initial rhythm was VF in 76% and pulseless VT in 24%. In relation to the context of the arrhythmic event, 48.3% occurred during daily life activities, 13.8% after an emotional stress, 6.9% during efforts and a similar percentage occurred either in rest or asleep. Of note, 12.5% of patients had previous history of syncope. Normal ECG was present in 83% of patients. Family history of SCD was present in 12% of the cases. As for the cardiovascular risk factors, 61.5% had hypertension, 19% dyslipidemia, 17% diabetes, 31% were smokers or previous smokers. Paroxysmal atrial fibrillation was present in 15% of patients. To exclude possible causes of VF, all patients were submitted to coronary angiogram and echocardiogram, 64% to genetic testing, 68% to cardiac magnetic resonance, 20% to electrophysiologic study, 12% to pharmacological provocative test and 4% were submitted to endomyocardial biopsy. At follow-up, an etiological diagnosis was established in 31% of patients: 3 events were attributed to coronary vasospasm, 3 to short coupled polymorphic VT, 1 patient had long QT syndrome, 1 had Brugada syndrome and in 1 patient an ANK2 mutation was identified. As for the clinical outcomes, 8% patients died (from non-arrhythmic causes), 31% patients received appropriate therapies and 19% had unappropriated shocks (of those 60% for sinus tachycardia and 40% for supraventricular tachycardia). Conclusion Etiologic diagnosis and prediction of recurrence of arrhythmic events in patients with idiopathic VF is challenging, even with a long-term follow-up and more sophisticated diagnostic evaluation.  Idiopathic VF is a rare but serious condition with recurrence in about one third of patients. Although not free of complications, ICD remains the gold standard of treatment.

3,4-methylene-dioxy-pyrovalerone (MDPV) epidemic?

2011 ◽  
Vol 152 (50) ◽  
pp. 2010-2019 ◽  
Author(s):  
Miklós Péter Kalapos
Keyword(s):  
Crucial Role ◽  
Panic Attack ◽  
Illicit Drugs ◽  
Drugs Of Abuse ◽  
Glucuronic Acid ◽  
Designer Drugs ◽  
Designer Drug ◽  
Clinical Observations ◽  
Speed Up ◽  
Street Price

Little is known about 3,4-methylene-dioxy-pyrovalerone (MDPV), a new designer drug that has become popular in Hungary in the last couple of months. At the same time, its consumption as a consequence of its low street-price rises so fast that the event can be considered as an epidemic. This paper reviews the chemistry, biochemistry and metabolism of MDPV, then, on the basis of few international reports and clinical observations of the author of his own, discusses MDPV intoxication and withdrawal. In the metabolism of MDPV, the most important catalyst is the CYP2C19 isoenzyme, but the CYP1A2 and the CYP2D6 isoenzymes also play a crucial role. The formed catechols are conjugated with either glucuronic acid or sulfate. It is important to note that MDPV is consumed either together or in a sequence with other illicit drugs of abuse. As far as it can be established, MDPV use increases the activity and vigilance, decreases appetite and claim to sleep, but it can also provoke cardiac sensations and disturbance of perception. In the course of coming down, withdrawal after MDPV use, bone and muscle pain, hypersomnia, disturbance of vision are experienced, but panic attack may also occur. The appearance of new designer drugs on the market draws attention to a need of paradigm changing in spiritual field. Unless it happens these negative trends shall speed up. Orv. Hetil., 2011, 152, 2010–2019.

scholarly journals Hypereosinophilic Syndrome, Cardiomyopathies, and Sudden Cardiac Death in Superinvasive Opisthorchiasis

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Vitaly G. Bychkov ◽  
Vladimir M. Zolotukhin ◽  
Elena D. Khadieva ◽  
Svetlana V. Kulikova ◽  
Ivan M. Petrov ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Heart Muscle ◽  
Cardiac Death ◽  
Myocardial Metabolism ◽  
Hypereosinophilic Syndrome ◽  
Cardiovascular Pathology ◽  
Healthcare Facilities ◽  
Icd 10

Cardiovascular pathology in patients with superinvasive opisthorchiasis is characterized by severe changes in haemodynamics and myocardial metabolism, impaired automatism, excitability, and conduction of the heart muscle. An analysis of 578 cases (medical and outpatient records and reports of pathoanatomical and forensic autopsies) recorded in healthcare facilities treating opisthorchiasis patients with a hyperendemic focus was carried out. We identified a set of cardiac changes in patients with hypereosinophilic syndrome associated with superinvasive opisthorchiasis infection, classified the pathological processes in accordance with ICD-10, and described their pathogenesis.

scholarly journals Low lung function, sudden cardiac death and non-fatal coronary events in the general population

2021 ◽  
Vol 8 (1) ◽  
pp. e001043
Author(s):  
Suneela Zaigham ◽  
Karl-Fredrik Eriksson ◽  
Per Wollmer ◽  
Gunnar Engström
Keyword(s):  
Sudden Cardiac Death ◽  
Lung Function ◽  
Cardiac Death ◽  
Cox Regression ◽  
Strong Predictor ◽  
Previous History ◽  
Coronary Event ◽  
Forced Expiratory Volume ◽  
P Value ◽  
Cardiac Events

BackgroundMany of those who suffer from a first acute coronary event (CE) die suddenly during the day of the event, most of them die outside hospital. Poor lung function is a strong predictor of future cardiac events; however, it is unknown whether the pattern of lung function impairment differs for the prediction of sudden cardiac death (SCD) versus non-fatal CEs. We examined measures of lung function in relation to future SCD and non-fatal CE in a population-based study.MethodsBaseline spirometry was assessed in 28 584 middle-aged subjects, without previous history of CE, from the Malmö Preventive Project. The cohort was followed prospectively for incidence of SCD (death on the day of a first CE, inside or outside hospital) or non-fatal CE (survived the first day). A modified version of the Lunn McNeil’s competing risk method for Cox regression was used to run models for both SCD and non-fatal CE simultaneously.ResultsA 1-SD reduction in forced expiratory volume in 1 s (FEV1) was more strongly associated with SCD than non-fatal CE even after full adjustment (FEV1: HR for SCD: 1.23 (1.15 to 1.31), HR for non-fatal CE 1.08 (1.04 to 1.13), p value for equal associations=0.002). Similar associations were found for forced vital capacity (FVC) but not FEV1/FVC. The results remained significant even in life-long never smokers (FEV1: HR for SCD: 1.34 (1.15 to 1.55), HR for non-fatal CE: 1.11 (1.02 to 1.21), p value for equal associations=0.038). Similar associations were seen when % predicted values of lung function measures were used.ConclusionsLow FEV1 is associated with both SCD and non-fatal CE, but consistently more strongly associated with future SCD. Measurement with spirometry in early life could aid in the risk stratification of future SCD. The results support the use of spirometry for a global assessment of cardiovascular risk.

scholarly journals Mechanisms of Damage to the Cardiovascular System in COVID-19

2021 ◽  
Vol 76 (3) ◽  
pp. 287-297
Author(s):  
Alexandr Y. Fisun ◽  
Yuriy V. Lobzin ◽  
Dmitry V. Cherkashin ◽  
Vadim V. Tyrenko ◽  
Konstantin N. Tkachenko ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiovascular System ◽  
Heart Muscle ◽  
Cardiac Death ◽  
Myocardial Damage ◽  
Angiotensin Converting Enzyme 2 ◽  
Coronary Syndrome ◽  
Life Threatening ◽  
Potential Benefits ◽  
Myocardial Involvement

The review article is devoted to the analysis of the literature on the various mechanisms of damage to the cardiovascular system in COVID-19. The article briefly outlines the epidemiology and urgency of the COVID-19 problem, describes the features of the clinical picture of heart muscle damage in COVID-19. The pathophysiology, morphology and pathogenetic mechanisms of myocardial involvement in cases of SARS-CoV-2 lesion are considered in detail. The authors present a diagram of various mechanisms of myocardial damage in COVID-19, which includes mediated damage to the heart muscle through angiotensin-converting enzyme 2, myocardial damage caused by hypoxemia, microvascular heart damage, and systemic inflammatory response syndrome. A detailed scheme of cardiomyocyte infection with the involvement of cytokines, which ultimately leads to myocardial remodeling and dilated cardiomyopathy, is presented. The pathophysiological foundations of the development of sudden cardiac death in COVID-19, which include the mechanisms of life-threatening arrhythmias, acute coronary syndrome, and heart failure, are considered. The authors analyzed scientific studies of the toxic effects of COVID-19 drug treatment on the heart muscle, in particular, antiviral, antibacterial, antimalarial agents. Their potential benefits and harms, as well as the likelihood of developing cardiovascular events, in particular sudden cardiac death, were assessed.

The risk of myocardial infarction and sudden cardiac death amongst snuff users with or without a previous history of smoking

2007 ◽  
Vol 262 (3) ◽  
pp. 360-367 ◽  
Author(s):  
P. Wennberg ◽  
M. Eliasson ◽  
G. Hallmans ◽  
L. Johansson ◽  
K. Boman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Previous History ◽  
History Of

A study of the morphological features of the heart muscle in sudden cardiac death

2020 ◽  
Vol 15 (3) ◽  
pp. 31-35
Author(s):  
S.N. Kolyubaeva ◽  
V.A. Kachnov ◽  
V.V. Tyrenko ◽  
V.S. Chirsky ◽  
L.S. Onishchenko ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Heart Muscle ◽  
Cardiac Death ◽  
Morphological Features

scholarly journals Aborted Sudden Cardiac Death and a Mother with Suspected Metabolic Myopathy

2014 ◽  
Vol 8 ◽  
pp. CMC.S16143
Author(s):  
Josef Finsterer ◽  
Claudia Stöllberger ◽  
Hans Keller
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Previous History ◽  
Young Female ◽  
Multiple Organ ◽  
Metabolic Myopathy ◽  
Initial Manifestation ◽  
Clinical Neurological Examination ◽  
The Family ◽  
History Of

Aborted sudden cardiac death (SCD) has not been reported as initial manifestation of cardiac involvement in metabolic myopathy (MM). A 20-year-old female with a previous history of three syncopes, hyperhidrosis, and recurrent tick bites experienced aborted SCD. Her mother presented with MM, and a history of pituitary adenoma, nephroptosis, arterial hypertension, depression, migraine, goiter, pancreatitis, osteoporosis, hyperhidrosis, multiple muscle ruptures, and hyperlipidemia. After a few days of disorientation and amnesia, the young female recovered completely. Clinical neurological examination was noticeable for partial ophthalmoparesis and mild hyperprolactinemia. She received an implantable cardioverter defibrillator, which did not discharge so far. Recurrent syncopes and aborted SCD may be the initial manifestation of MM with multiple organ involvement. The family history is important in cases with aborted SCD to guide the diagnostic work-up. Phenotypic heterogeneity between the family members may be an indicator of MM.

Sign in / Sign up

Export Citation Format

Share Document