DOI: 10.11648/j.ccr.20261004.11 ISSN: 2578-8914

ST-Segment Elevation in Methamphetamine-Users Adolescents: An Emerging Treatment Paradigm, Case Report

Eduardo Quintero, Saul Jalpilla, Carolina Herrera, Ingrid Cabrera, Ivonne Lopez, Fernanda Solares, Vanessa Jimenez
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Antecedents: Objective: Present the electrocardiographic changes secondary to methamphetamine use in an adolescent. Given that this is a pioneer case in the national literature, we consider its dissemination appropriate. Case Report: A 17-year-old obese female adolescent, smoker and methamphetamine (crystal) user, presented with ST-segment elevation (STE) 12 hours after a binge, without accompanying anginal equivalents. With the application of anti-ischemic and antithrombotic measures, improvement of the STE was observed on the follow-up electrocardiogram (ECG) 24 hours later. The patient did not develop cardiogenic shock or arrhythmias. Thrombolysis was not performed because she did not develop pathological Q waves. Total creatine phosphokinase (CPK) and creatine phosphokinase- MB (CPK-MB) levels were elevated, due to rhabdomyolysis. Conclusions: ST-segment elevation in methamphetamine users has been termed benign coronary spasm by some authors; however, due to the risk of thromboinflammation at the glycocalyx level, the problem could out-come obstructive. There is no consensus regarding treatment in pediatric patients. Treatment in adults prioritizes vasodilation and antithrombotic measures, especially in presence of cardiovascular risk factors such as obesity and smoking.

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