Amphetamine abuse in the general population in the Netherlands is relatively limited and stable. Approximately 0.2% of the Dutch population used amphetamine in 2005. Fatal cases of amphetamine-associated cardiotoxicity (myocardial infarction or necrosis, acute cardiac failure or cardiac arrhythmia) are rarely reported in medical literature.
This report describes the case of a 31-year-old male standing in front of his bedroom window, swinging an axe and threatening to jump. During a struggle with the police in which pepper spray was used, the patient suddenly collapsed and lost consciousness. Police officers immediately started with basic life support. After twenty-one minutes of resuscitation there was a sinus tachycardia and output. The evening prior to his struggle with the police, the patient had smoked 1.5 gram of speed. Toxicological analysis in the patient’s urine revealed a concentration of 26 mg/L of amphetamine (toxicological level >0.2 mg/L) and 18 ųgr/L of methamphetamine (toxicological level >0.2 mg/L). No traces of pepper spray were found. Initial electrocardiogram revealed diffuse ischemia. On our ICU, refractory cardiogenic shock developed and was eventually followed by death, approximately 30 hours after admission.
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