Key result
Anti-ischemic and antithrombotic therapy resolves methamphetamine-induced ST-segment elevation within 24 hours without Q waves.
Why the study?
This case presents electrocardiographic changes secondary to methamphetamine use in an adolescent, representing a pioneer report in the national literature where consensus regarding treatment in pediatric patients is lacking.
Case Report (n=1)
No
This case report demonstrates that methamphetamine-induced ST-segment elevation in an adolescent with cardiovascular risk factors can improve within 24 hours using vasodilator, anti-ischemic, and antithrombotic therapy without thrombolysis.
May support conservative therapy for methamphetamine-induced ST elevation in adolescents; leaves open need for prospective validation.
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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Quintero et al. (2026) conducted a case report in ST-segment elevation secondary to methamphetamine use (n=1). Anti-ischemic and antithrombotic therapy (clopidogrel, aspirin, atorvastatin, low-molecular-weight heparin, and nitroglycerin patch) was evaluated on Improvement of ST-segment elevation on follow-up electrocardiogram at 24 hours. Anti-ischemic and antithrombotic therapy improved methamphetamine-induced ST-segment elevation within 24 hours in a 17-year-old adolescent without developing Q waves or arrhythmias.
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