Case Report
ST-Segment Elevation in Methamphetamine-Users Adolescents: An Emerging Treatment Paradigm, Case Report
Issue:
Volume 10, Issue 4, December 2026
Pages:
106-111
Received:
19 August 2026
Accepted:
16 September 2026
Published:
20 October 2026
Abstract: 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.
Abstract: 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 elevatio...
Show More
Case Report
Non-Coronary Left Ventricular Pseudoaneurysm Diagnosed During the Evaluation of Pericarditic Chest Pain in a Young Woman in Benin: A Case Report
Carmel Gloria Abatti*
,
Rachad Kondo Moussa,
Borelle Padonou,
Félicité Agbayi,
Fustel Sossa,
Tibaud Ebessa,
David Mawu-Kolo Bokodaho,
Francis Soummonni,
David Dossou,
Xavier Fadonougbo,
Philippe Agbalika,
Murielle Hounkponou,
Djidjoho Joël Arnaud Sonou,
Léopold Houétondji Codjo
Issue:
Volume 10, Issue 4, December 2026
Pages:
112-117
Received:
20 October 2026
Accepted:
28 October 2026
Published:
12 November 2026
Abstract: Left ventricular (LV) pseudoaneurysm is a contained rupture of the myocardial wall sealed off by the pericardium. It usually complicates myocardial infarction or cardiac surgery, whereas non-coronary forms are exceptional, particularly in young patients, and their etiology is often difficult to establish. We report the case of a 27-year-old woman with an unspecified childhood heart disease, admitted for prolonged pericarditic chest pain associated with fever, cough, weight loss and New York Heart Association (NYHA) class III dyspnea. Examination showed sinus tachycardia at 100 beats per minute, a body mass index of 18.97 kg/m2 and isolated jugular venous distension. The electrocardiogram showed PR segment depression, and the chest radiograph showed cardiomegaly (cardiothoracic ratio 0.60) with a bulge of the left middle cardiac border. Transthoracic echocardiography, performed for the work-up of this chest pain, revealed a communicating LV pseudoaneurysm of the basal anterolateral wall (55 mm in diameter, 28 mm neck, no thrombus) and a moderate fibrinous pericardial effusion. Cardiac magnetic resonance imaging confirmed the diagnosis (sac of 62 × 49 mm) and showed no myocardial enhancement suggestive of myocarditis. Laboratory tests showed multifactorial anemia (hemoglobin 8.3 g/dL) with signs suggestive of hemolysis and a C-reactive protein level of 96 mg/L; blood cultures and the tuberculosis work-up were negative. The patient received high-dose aspirin and weight-adjusted colchicine, as first-line therapy for acute pericarditis, and a blood transfusion, with a favorable course after two weeks of hospitalization. Surgical repair was indicated, but cardiac surgery was not available in the country at that time. While awaiting a state-organized cardiac surgery mission, the patient was lost to follow-up, reportedly had four episodes of decompensated heart failure, and died of sudden circulatory collapse in October 2024, approximately nine months after diagnosis. No autopsy was performed; rupture of the pseudoaneurysm is suspected but remains a hypothesis. The etiology remains undetermined, and a congenital and/or infectious (pericardial) origin is possible but unproven. Echocardiography is the first-line examination, and because of the risk of rupture, surgical repair is recommended even in asymptomatic patients and should be made accessible in low-resource settings.
Abstract: Left ventricular (LV) pseudoaneurysm is a contained rupture of the myocardial wall sealed off by the pericardium. It usually complicates myocardial infarction or cardiac surgery, whereas non-coronary forms are exceptional, particularly in young patients, and their etiology is often difficult to establish. We report the case of a 27-year-old woman w...
Show More
