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"apellidos" => "Perea" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Xavier" "apellidos" => "Bosch" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Cardiología, Instituto Clínic Cardiovascular, Hospital Clínic, Universidad de Barcelona, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Radiodiagnóstico, Hospital Clínic, Universidad de Barcelona, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lesión miocárdica en consumidor de <span class="elsevierStyleItalic">shabú:</span> patrón multifocal de realce tardío de gadolinio" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 951 "Ancho" => 1035 "Tamanyo" => 123040 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 38-year-old Philippine male presented with edemas. He was a consumer of “<span class="elsevierStyleItalic">shabu</span>” (crystal methamphetamine) and smoker. Physical examination revealed hypertension, crackles and jugular ingurgitation. Chest X-ray revealed cardiomegaly. Electrocardiogram showed asymmetrical inverted T waves in lateral and inferior leads. Coronary heart disease was excluded by coronary angiography.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Echocardiography showed severely reduced left ventricular ejection fraction (LVEF25%), mild left ventricular dilatation and left ventricular hypertrophy. Cardiac magnetic resonance imaging (CMRI) evidenced hypertrophy (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A) and multiple foci of late gadolinium enhancement (LGE) in lateral and inferior segments (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B–D yellow-arrows); the foci were transmural, subepicardial, and subendocardial. In addition, right ventricle presented LGE in free and inferior segments (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B and C, red-arrows). Because of this LGE pattern, a computerized tomography was performed and sarcoidosis was ruled out. After excluding the most plausible etiology of heart failure, toxic myocarditis diagnosis was accepted.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Myocardial injury diagnosed as multiple foci of LGE has been described with cocaine, but not with <span class="elsevierStyleItalic">shabu</span>. <span class="elsevierStyleItalic">Shabu</span> is a methamphetamine consumed smoked. Its consumption has been associated with hypertension, dilated cardiomyopathy, and heart failure. With this image we suggest a possible relationship between <span class="elsevierStyleItalic">shabu</span> use, myocardial injury and multiple foci of LGE. Cardiovascular side effects of use of <span class="elsevierStyleItalic">shabu</span> needs further research.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Pujol-López M, Ortega-Paz L, Perea RJ, Bosch X. Lesión miocárdica en consumidor de <span class="elsevierStyleItalic">shabú:</span> patrón multifocal de realce tardío de gadolinio. Med Clin (Barc). 2016;147:570.</p>" ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 951 "Ancho" => 1035 "Tamanyo" => 123040 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000014700000012/v1_201702040025/S2387020616307823/v1_201702040025/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000014700000012/v1_201702040025/S2387020616307823/v1_201702040025/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020616307823?idApp=UINPBA00004N" ]
Journal Information
Vol. 147. Issue 12.
Pages 570 (December 2016)
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Vol. 147. Issue 12.
Pages 570 (December 2016)
Image in medicine
Myocardial injury in a Shabu user: late gadolinium multiphocal enhancement
Lesión miocárdica en consumidor de shabú: patrón multifocal de realce tardío de gadolinio
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