Pulmonary Arterial Hypertension Associated With Chronic Mephedrone Use: A Case Report

Mephedrone is a synthetic cathinone with sympathomimetic effects, but has not previously been linked to pulmonary arterial hypertension (PAH). We report a 42‐year‐old woman with no prior cardiopulmonary disease who presented with severe pre‐capillary PAH after a decade of near‐daily mephedrone use. Extensive evaluation—including autoimmune, infectious, genetic, and imaging studies—excluded recognised causes of PAH. Following cessation of mephedrone and initiation of dual oral PAH‐targeted therapy, she demonstrated substantial initial clinical and haemodynamic improvement; however, the response remained incomplete, necessitating further treatment escalation with selexipag. This appears to be the first reported case of PAH linked to mephedrone use.