J-LSMS | Abstracts | 2020 Annual LaACP Meeting

Weighing the Benefit of an “All - nighter” with the Risk of a Cardiomyopathy: An Atypical Case of

Adderall Induced Stress Cardiomyopathy

G. Paterson Graham, Fellow, Cardiovascular Disease, Tulane University Heart and Vascular Institute,

New Orleans, LA.

Ashley Russell, Resident, Internal Medicine, Tulane University, New Orleans, LA.

Rohan Samson, Assistant Professor, Associate Program Director, Cardiovascular Disease, Tulane

University Heart and Vascular Institute, New Orleans, LA.

Aaron Sweeney, Assistant Professor, Cardiovascular Disease, Tulane University Heart and Vascular

Institute, New Orleans, LA.

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Introduction:

Adderall is a stimulant drug consisting of amphetamine and dextroamphetamine, and it is one of many

FDA approved stimulants used for Attention-Deficit/Hyperactivity Disorder (ADHD). The use of stimulant

medications continues to rise in the United States. With the increasing use and misuse of stimulant

medications, it is imperative to monitor and recognize the serious side effects of the medications -

specifically that of stress-induced cardiomyopathy. We describe a case of a young gentleman who

develops a rare type of stress cardiomyopathy with minimal Adderall use.

Case Presentation:

A healthy 19-year-old African American male arrived at the Emergency Department for severe sharp

chest pain and palpitations. ECG showed sinus tachycardia without ST changes. Laboratory data

revealed a Troponin I of 6.9 and a pro-BNP of 73. A transthoracic echocardiogram showed an ejection

fraction (EF) of 15% with akinesis of the base with only mid-ventricular and apical walls contracting

consistent with reverse, or basal, Takotsubo cardiomyopathy (TC). A coronary angiogram did not show

atherosclerotic disease. The patient revealed that he took two pills of his friend’s Adderall the night prior

to help him stay awake. Despite starting appropriate medical therapy, the patient’s EF did not improve

significantly over the 7 days in the hospital prior to his discharge.

Discussion:

Reverse TC, also known as “Basal” or “Inverted” TC, represents 2.2% of all Takotsubo cases according to

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