Ecstasy as a Potential Cause for Diffuse ST Elevation in a 27-Year-Old Healthy Male: A Case Report.

A 27-year-old previously healthy man developed oppressive chest pain and diffuse ST-segment elevation on his electrocardiogram several days after using ecstasy (MDMA). His troponin level was normal, and coronary angiography showed no blockages, consistent with coronary vasospasm rather than a heart attack. MDMA increases serotonin, dopamine, and noradrenaline, which can trigger vasospasm. Though conclusive evidence linking MDMA to acute coronary syndrome is limited, cases of transient vasospasm and thrombosis have been reported, indicating that prompt evaluation is needed for chest pain after ecstasy use.

Study at a glance

Abstract

Ecstasy, also known as 3,4-methylenedioxymethamphetamine (MDMA), is widely used as a recreational drug known for its stimulating effects. While acute coronary syndrome and coronary vasospasm are frequently observed following cocaine and methamphetamine use, there have been few reported cases linking them to ecstasy use. We present a case of a 27-year-old, previously healthy, male presenting with oppressive retrosternal chest pain and diffuse ST-segment elevation, despite a normal troponin, several days after ecstasy use. His presentation followed by a normal coronary angiography is most consistent with an episode of coronary vasospasm. It is plausible that the consumption of MDMA contributed to this presentation. MDMA can lead to cardiovascular issues by increasing serotonin, dopamine, and noradrenaline levels, which may cause symptoms like coronary vasospasm. Although conclusive evidence linking MDMA to acute coronary syndrome is limited, cases of transient coronary vasospasm and thrombosis have been reported, suggesting a need for prompt evaluation and management of such conditions.