A young man with acute dilated cardiomyopathy associated with methylphenidate

Case report

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Authors: Tor-Bjarne Nymark, A Hovland, H Bjørnstad, E W Nielsen

Published Date May 2008 Volume 2008:4(2) Pages 477 - 479

DOI: http://dx.doi.org/10.2147/VHRM.S2410

Tor-Bjarne Nymark¹, A Hovland², H Bjørnstad², E W Nielsen^1,3

¹Section for Emergency Medicine; ²Department of Cardiology, Nordland Hospital, Bodø, Norway; ³University of Tromsø, Tromsø, Norway

Abstract: An 18-year-old obese man with a body mass index of 40, diagnosed with attention-deficit hyperactivity disorder and treated with methylphenidate (Concerta^®) was acutely admitted to hospital with hypoxia and dyspnoea. On investigation signs of liver-, renal-, and heart-failure were found. Noradrenalin infusion was started. Echocardiography showed dilated left ventricle and an ejection fraction (EF) of 25%. Liver function improved, noradrenalin and dobutamine were tapered, but three days after admission a new echocardiography showed an EF of 10%. The patient was transferred to the National Hospital (Rikshospitalet, Oslo), where intensified treatment including intra aortic balloon pump (IABP) was instituted. Cardiac function improved, and 3 weeks later the IABP was disconnected. EF at this point was 15%. The patient was denied heart transplantation due to various cofactors. The investigation concluded with a probable relationship between his cardiomyopathy and the use of methylphenidate (Concerta).

Keywords: cardiomyopathy, heart failure, ADHD, methylphenidate