Ecstasy as a Potential Cause for Diffuse ST Elevation in a 27-Year-Old Healthy Male: A Case Report.
Rabih Nasrallah, Amin Ossaily, Mazen Al Hammoud, Anwar Nader, Georges Ghanem
Cureus June 1, 2025 DOI: 10.7759/cureus.85795 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 27-year-old previously healthy male |
| Topics | MDMA |
| Keywords | Acute coronary syndrome Case report Coronary vasospasm Stimulant-related heart problems Drug-induced cardiovascular events MDMA Cardiovascular Effects Ecstasy heart complications Heart attack Myocardial infarction Cardiac event Unstable angina Patient case Medical observation Clinical finding Case study |
| Citations | 2 |
| Key findings | A 27-year-old man presented with chest pain and ST-segment elevation after ecstasy use, with normal angiography suggesting coronary vasospasm as the cause. |
Abstract
Ecstasy, also known as 3,4-methylenedioxymethamphetamine (MDMA), is widely used as a recreational drug known for its stimulating effects. While acute coronary syndrome and coronary vasospasm are frequently observed following cocaine and methamphetamine use, there have been few reported cases linking them to ecstasy use. We present a case of a 27-year-old, previously healthy, male presenting with oppressive retrosternal chest pain and diffuse ST-segment elevation, despite a normal troponin, several days after ecstasy use. His presentation followed by a normal coronary angiography is most consistent with an episode of coronary vasospasm. It is plausible that the consumption of MDMA contributed to this presentation. MDMA can lead to cardiovascular issues by increasing serotonin, dopamine, and noradrenaline levels, which may cause symptoms like coronary vasospasm. Although conclusive evidence linking MDMA to acute coronary syndrome is limited, cases of transient coronary vasospasm and thrombosis have been reported, suggesting a need for prompt evaluation and management of such conditions.
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
Cites 3
- Ecstasy induced acute systolic heart failure and Non-Ischemic Cardiomyopathy in a young female: a rare case report and literature review Journal of Community Hospital Internal Medicine Perspectives September 6, 2019
- MDMA toxicity: management of acute and life-threatening presentations. British journal of nursing June 14, 2018
- The pharmacology and clinical pharmacology of 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy"). Pharmacological Reviews September 2003