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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