Discussions By Condition: Medical Stories

One time amphetamine use and long term effect on the heart

Posted In: Medical Stories 4 Replies
  • Posted By: eho123
  • October 20, 2010
  • 02:55 AM

I am a 27 year old PhD student in Los Angeles. My life has been pretty stressful over the last 2 years due to work, and more recently due to a personal relationship.

About two months ago I had a quite significant breakthrough in my research, and while working on it I felt some chest discomfort - however I disregarded it attributing it to the stress and me being out of shape. Also that day I was significantly more productive than usual, and was able to focus very well.

The next day I felt extremely weak and fatigued, and went to bed early in the evening. Upon waking up in the morning, I was unusually talkative - talked straight from 6 am to 12 pm without stopping. Then in the afternoon, I felt a sudden rush of adrenalin - my heart rate started going really high, and I had something like an out of body experience. It didn't take too long to realize that something was wrong with me, and at one point with my heart rate going really high I feared I was having a heart attack, so I asked my friend to call an ambulance. Upon their arrival - they said they suspected I was on drugs, and told me I was unlikely to be having a heart attack due to my age.

It was an embarrassing experience for me because, I've never been a similar situation before. So I went home.
The next day at work the palpitations started again with a renewed intensity - I could hardly concentrate. I ended up in urgent care in extreme pain - my heart rate was at 150 upon arrival, my blood pressure at 150/90. I was squirming on the floor in pain. They started treating me for a heart attack - and run a multitude of tests.

Everything was normal, except for the huge amount of amphetamine in my urine. I wasn't even sure what the doc was talking about when he asked me if I'd taken speed or crystal meth or whatever else. I didn't even know what that looked like. I was discharged, and the tachycardia was attributed to the meth in my body. They prescribed metroprolol, and told me it would take a couple of days for the meth to flush out of my system.

Well, it did - and I was gradually recovering for the next week - I even did a walking hike of 10 miles during the weekend.

However, over a week later I had to go pick up my partner from the airport. While I was driving I had this strange sensation of warmth on my chest - immediately I thought I was having a heart attack - and had to exit the freeway. I felt very weak for the rest of that day. My doc referred me to a psychiatrist and they diagnosed with panic disorder.

I never really had panic attacks before the episode with the meth, but after this my life went on a downward spiral. I was having those so called attacks almost every day, and I was living under constant anxiety of impending death.
I was feeling constant soreness on my chest, my muscles were spasming, I was having hot flashes all over my my body. I was referred to a cardiologist - he ran a 24 hour urine test for adrenal problems, an echocardiogram, a thyroid blood test. They were all normal.

After 3 false visits to the ER for a heart attack, I have now resigned myself to the fact that I am suffering from an anxiety disorder. However, my symptom are not improving they are getting worse. I am getting pain in the back, and in the chest on exertion. I am becoming short of breath quite easily. Also I have tingling in my left arm, and sometimes even shooting pain. Those usually appear when my heart rate becomes elevated for no reason at all.

I am not sure what to do any more. Is this really just anxiety, or could that single dose of amphetamine have damaged my heart? Or could I be having withdrawal symptoms from just one single dose of amphetamine?

If this is just anxiety, I am reluctant to take any psychiatric medication. The psychiatrist initially told me to continue taking the beta blockers, but they made my so-called panic attacks worse, so I abruptly stopped taking them (not a good idea I know). Then she prescribed Xanax - but reading some horror stories online about how easily people can get addicted to that - I would rather endure the panic attacks than take that pill.

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4 Replies:

  • Xanax. Mmmm.Only cost me a car, almost my friends life, and almost mine. =\Other than that, I recommend it fully. =)Don't worry about the fact that it has a 95% addiction rate, can't be that bad.Seriously, don't take it. I have an idea, and I'd like for you to test it out the next time you have an attack. It's a technique called the Valsalva maneuver, and it can be used to interrupt the fast heartbeat. Hold your breath and strain, as if you were trying to have a bowel movement, or cough while sitting with your upper body bent forward.Now, could this be your problem?Paroxysmal supraventricular tachycardia (PSVT):An occasional rapid heart rate. "Paroxysmal" means from time to time.SymptomsAnxietyChest tightnessPalpitations (a sensation of feeling the heart beat)Rapid pulseShortness of breathAdditional symptoms that may be associated with this condition:DizzinessFaintingNote: Symptoms may start and stop suddenly, and can last for a few minutes or several hours. A PSVT lasting more than half of the day is considered an incessant PSVT.TreatmentIf you do not have symptoms, PSVT may not require treatment.If symptoms occur or if you have another heart disorders, treatment may be necessary.Splashing ice water on the face has been reported by some people as helpful.Emergency treatment of PSVT may include:Electrical cardioversion, the use of electric shock to restore a rapid heartbeat back to normal.Medicines through a vein, including adenosine and verapamil. Other medications may be used, such as procainamide, beta-blockers, and propafenone.Long-term treatment of PSVT may include:Daily medications such as propafenone, flecainide, moricizine, sotalol, and amiodarone.Radiofrequency catheter ablation; currently the treatment of choice for most PSVT's.Surgery to change the pathways in the heart that send electrical signals; this may be recommended in some cases for people who need other heart surgery.CausesNormally, the chambers of the heart (atria and ventricles) contract in a coordinated manner. The contractions are caused by an electrical signal that begins in an area of the heart called the sinoatrial node (also called the sinus node or SA node). The signal moves through the upper heart chambers (the atria) and tells the atria to contract.PSVT starts with events taking place above the lower heart chambers (ventricles). PSVT can be initiated in the SA node, in the upper heart chambers (atria), in the atrial conduction pathways, or other areas.PSVT can occur with digitalis toxicity and conditions such as Wolff-Parkinson-White syndrome.The condition occurs most often in young people (you ain't exactly old my friend =p) and infants.The following increase your risk for PSVT:Alcohol useCaffeine useIllicit drug useSmokingTests & diagnosisA physical examination during a PSVT episode will show a rapid heart rate.The heart rate may be 150 to 250 beats per minute (bpm). There may be signs of poor blood circulation such as light headedness. Between episodes of PSVT, the heart rate is normal (60 to 100 bpm).An ECG during symptoms shows PSVT. An electrophysiology study (EPS) is often necessary for an accurate diagnosis and to recommend the best treatment.Because of the sporadic nature of the PSVT, its diagnosis may require 24-hour Holter monitoring. For longer recording periods, a "loop recorder" (with computer memory) is used.I hope you get these under control, as it would be a true shame if a brilliant mind was lost to heart failure.
    keanhe 86 Replies
    • October 23, 2010
    • 07:47 AM
    • 0
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  • If you happen to check this post again, are you still suffering from these symptoms? If beta blockers made it worse, Wolff Parkinson White syndrome is something you might want to research, if you haven't already been tested for it...If it really is anxiety disorder/panic attacks, I can suggest quite a bit that might help, but I wanted to check to see if you're even reading this forum before I write a long reply about that... One thing to remember though; you can't die from panic attacks. No matter how terrifying they feel, they've never caused one single death. Sometimes just knowing that alone helps stave them off, along with the reassurance that you're not going crazy, and that millions of other people know what you're going though (and it can get better -- my situation started and exacerbated almost exactly like yours, to the point I was having attacks every other day -- yet now, 12 years later, I can count the number of attacks I've had since then on one hand)...
    Anonymous 42,789 Replies Flag this Response
  • I have gotten a bit better - but I still get dizzy spells, accompanied by a high heart rate. While researching on my condition, I found out that beta blockers should never be prescribed to treat amphetamine toxicityFrom wikipedia: http://en.wikipedia.org/wiki/Beta_blockerBeta blockers must not be used in the treatment of cocaine, amphetamine, or other alpha adrenergic stimulant overdose. The blockade of only beta receptors increases hypertension, reduces coronary blood flow, left ventricular function, and cardiac output and tissue perfusion by means of leaving the alpha adrenergic system stimulation unopposed. The appropriate antihypertensive drugs to administer during hypertensive crisis resulting from stimulant abuse are vasodilators like nitroglycerin, diuretics like furosemide and alpha blockers like phentolamine.I also found a similar description on the emedicine site, which clearly states that amphetamine intoxication should never be treated with beta blockers, as mixing the two can cause vasoconstriction - which I suppose explains some of the chest tightness I've been feeling. Right now, I'm just waiting to see if it will go away on its own. I've been talking with my cardiologist, and he thinks there is nothing wrong with me - that it's just stress/anxiety related.
    eho123 2 Replies Flag this Response
  • I am slowly getting better, but I am still having a few dizzy spells accompanied by a high heart rate. I'd like to exercise, but since I am so out of shape it’s pretty hard to do without exacerbating my dizziness and high heart rate. I think part of the reason why my condition got so bad is because I was given beta blockers (the notorious metoprolol tartrate). Through my own research I found out that beta blockers should never be used to treat amphetamine toxicity. For example, the wikipedia article on Beta Blockers has this short paragraphs:http://en.wikipedia.org/wiki/Beta_blockerBeta blockers must not be used in the treatment of cocaine, amphetamine, or other alpha adrenergic stimulant overdose. The blockade of only beta receptors increases hypertension, reduces coronary blood flow, left ventricular function, and cardiac output and tissue perfusion by means of leaving the alpha adrenergic system stimulation unopposed. The appropriate antihypertensive drugs to administer during hypertensive crisis resulting from stimulant abuse are vasodilators like nitroglycerin, diuretics like furosemide and alpha blockers like phentolamine.There is also an article on emedicine.com on how to treat amphetamine intoxication, and that one also explicitly states to never administer or prescribe beta-blockers. I took them for a few days, and later I was referred to a psychiatrist, and since I did not want to take xanax or any anti-depressants, she insisted I continue taking the beta-blocker metroprolol. While I was taking it, my panic attacks got progressively worse. So given the unfortunate incident with the amphetamine poisoning, the beta-blocker which should not have been prescribed, and possible pre-existing anxiety disorder, I was pretty unlucky and was in a really bad shape. Had I actually not sought medical treatment for the amphetamine overdose, I think I might actually be in a better shape, since I would have never been prescribed the metroprolol.Anyway, I am still getting dizzy, short of breath sometimes, and get cold extremities. But I am trying to live with these symptoms for now. I am really tired of chasing doctors - as they haven’t been able to help me at all.
    eho123 2 Replies Flag this Response
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