Ecstasy-Induced Rhabdomyolysis Leading to Severe Acute Kidney Injury Requiring Temporary Hemodialysis: A High Risk for Recurrence With Repeated Exposure.

Ecstasy (3,4-methylenedioxymethyl-amphetamine, MDMA) is an illicit drug that has found widespread use. It is mostly used by adolescents and young adults, particularly during intense and prolonged dance parties for its mood-enhancing properties. Despite these pleasurable effects, users may have potentially serious side effects including death. One of the serious side effects is rhabdomyolysis, which can proceed to severe acute kidney failure. Due to different personal characteristics, some individuals taking the same dose of MDMA may experience more adverse effects than others. Individuals who experience adverse effects are more likely to experience them with each use. Our patient used MDMA two times in his life, and on each occasion, he had severe rhabdomyolysis with severe acute kidney injury (AKI) requiring temporary hemodialysis. Health professionals should screen all adolescents and young adults for illicit drug use during each encounter and counsel them against it.

A Rare Case of Takotsubo Cardiomyopathy in a Patient With No Identifiable Emotional or Physical Stressors.

Takotsubo cardiomyopathy (TCM) is a cardiac condition that presents with features of acute myocardial infarction and transient systolic dysfunction without angiographic findings of obstructive coronary heart disease. Common presenting symptoms include acute substernal chest pain, dyspnea and syncope. It is usually triggered by recent emotional or physical stress such as head trauma, stroke, sepsis, overproduction of catecholamines such as pheochromocytoma or following Myasthenia crisis. We are here to report a case of TCM who does not have any identifiable emotional or physical stress prior to the event. The patient was a 76-year-old Caucasian female with a past medical history of hypertension who presented to the hospital with chest pain which initially was treated as non-ST elevation myocardial infarction (NSTEMI) with aspirin, ticagrelor and heparin infusion. Cardiac catheterization later revealed non-obstructive coronary artery disease but showed akinesis of inferior, apical and anterior walls with hyperdynamic basal segments indicating TCM.