Clinical Characteristics and Management of Methamphetamine-Associated Cardiomyopathy: State-of-the-Art Review

J Am Heart Assoc. 2020 Jun 2;9(11):e016704. doi: 10.1161/JAHA.120.016704. Epub 2020 May 29.

Abstract

Methamphetamine-associated cardiomyopathy (MACM) is an increasingly recognized disease entity in the context of a rapidly spreading methamphetamine epidemic. MACM may afflict individuals with a wide range of ages and socioeconomic backgrounds. Presentations can vary greatly and may involve several complications unique to the disease. Given the public health significance of this disease, there is a relative dearth of consensus material to guide clinicians in understanding, diagnosing, and managing MACM. This review therefore aims to: (1) describe pathologic mechanisms of methamphetamine as they pertain to the development, progression, and prognosis of MACM, and the potential to recover cardiac function; (2) summarize existing data from epidemiologic studies and case series in an effort to improve recognition and diagnosis of the disease; (3) guide short- and long-term management of MACM with special attention to expected or potential sequelae of the disease; and (4) highlight pivotal unanswered questions in need of urgent investigation from a public health perspective.

Keywords: cardiomyopathy; diagnosis; heart failure; management; methamphetamine.

Publication types

  • Review

MeSH terms

  • Amphetamine-Related Disorders / complications
  • Amphetamine-Related Disorders / diagnosis
  • Amphetamine-Related Disorders / rehabilitation*
  • Animals
  • Cardiomyopathies / chemically induced
  • Cardiomyopathies / diagnostic imaging
  • Cardiomyopathies / physiopathology
  • Cardiomyopathies / therapy*
  • Central Nervous System Stimulants / adverse effects*
  • Heart / diagnostic imaging
  • Heart / drug effects*
  • Heart / physiopathology
  • Humans
  • Methamphetamine / adverse effects*
  • Predictive Value of Tests
  • Recovery of Function
  • Risk Factors
  • Treatment Outcome

Substances

  • Central Nervous System Stimulants
  • Methamphetamine