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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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Perea, Xavier Bosch" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Margarida" "apellidos" => "Pujol-López" "email" => array:1 [ 0 => "mapujol@clinic.cat" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Luis" "apellidos" => "Ortega-Paz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Rosario J." 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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. 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