Acute ascending aortic dissection after MDMA/ecstasy use: A case report.
Satoko Kanahara, Mostafa El-Refai, Nasser Lakkis, Rashed Tabbaa
Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese 2016 DOI: 10.1016/j.hjc.2016.11.026 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A 37-year-old female with a history of hypertension presenting with syncope and altered mental status |
| Measures | Transthoracic echocardiogram, transesophageal echocardiogram |
| Topics | MDMA |
| Keywords | 3,4-methylenedioxymethamphetamine Acute aortic dissection Aortic regurgitation |
| Key findings | The authors report an acute DeBakey Type I aortic dissection in a 37-year-old woman after MDMA ingestion, diagnosed early by echocardiography, which showed dissection flaps and wide-open aortic regurgitation despite a normal tricuspid aortic valve. They state this is the second such case in the literature and argue that MDMA should be recognized as a risk factor for acute aortic dissection, particularly in younger patients. |
Abstract
Acute aortic dissection is rare among young patients in the absence of connective tissue disorders. One of the risk factors associated with aortic dissection among young patients is amphetamine use. We report a case of a 37-year-old female with a past medical history of hypertension presenting with syncope and altered mental status who was found to have an acute DeBakey Type I aortic dissection after ingestion of 3,4-methylenedioxymethamphetamine (MDMA), commonly known as ecstasy. This is the second case in the literature describing aortic dissection in relation to MDMA use. In both cases, the patients were young and had no history of connective tissue disorders or underlying valvular abnormalities. In this case, echocardiography was used to establish the diagnosis early. A transthoracic echocardiogram revealed a possible dissection flap prolapsing in through a normal aortic valve. Subsequently, a transesophageal echocardiogram revealed wide-open aortic regurgitation with several proximal dissection flaps from a normal caliber ascending aorta prolapsing into a normal tricuspid aortic valve. A high index of suspicion is necessary to diagnose and treat aortic dissection in young patients with a history of MDMA use. Recognize MDMA as a risk factor for acute aortic dissection, especially among younger patients with whom clinicians may not often associate aortic dissection.
Comparable studies
Other case reports and case series on MDMA, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| 'Eve' and 'Ecstasy'. A report of five deaths associated with the use of MDEA and MDMA Individuals whose deaths were associated with MDMA or MDEA use | 1987 | Case series | n = 5 |
| Pathology of deaths associated with "ecstasy" and "eve" misuse. Young white men aged 20 to 25 who died after using ring-substituted amphetamines (MDMA... | 1996 | Case series | n = 7 |
| 'Eve' and 'Ecstasy' Individuals who died after using MDMA or MDEA | 1987 | Case series | n = 5 |
| A Method of Conducting Therapeutic Sessions with MDMA Clients with clear therapeutic purpose, excluding those with serious functional... | 1998 | Case study | n = 2 |
| Diversity of Psychopathology Associated with use of 3,4-Methylenedioxymethamphetamine (‘Ecstasy’) Psychiatric patients presenting between 1990 and 1992 whose symptoms developed in the... | 1994 | Case series | n = 13 |
Citations in the library
Cited by 2
- Ecstasy (3,4-methylenedioxymethamphetamine): cardiovascular effects and mechanisms. European Journal of Pharmacology May 7, 2021
- First Time View on Human Metabolome Changes after a Single Intake of 3,4-Methylenedioxymethamphetamine in Healthy Placebo-Controlled Subjects Journal of Proteome Research July 19, 2017