International Journal of the Cardiovascular Academy · Published 2026-06-22 · DOI 10.4274/ijca.2026.44366
Tamaz Kheladze, Vache Shiolashvili, Mariam Lomidze, Nana Gonjilashvili, Tengiz Verulava
The global prevalence of methamphetamine and other amphetamine-type stimulants (ATS) continues to rise, contributing substantially to cardiovascular morbidity and mortality. ATS-associated cardiomyopathy (ATSAC) is an increasingly recognized but underdiagnosed cause of heart failure in young adults. This case report aims to describe the clinical presentation, management, and outcome of ATSAC and to highlight its potential reversibility with stimulant cessation and guideline-directed medical therapy (GDMT). A 24-year-old male with a long-standing history of polysubstance ATS abuse presented with progressive dyspnea and symptoms of acute decompensated heart failure. Comprehensive clinical evaluation, laboratory testing, echocardiography, and cardiac magnetic resonance imaging excluded alternative etiologies of cardiomyopathy. On admission, the patient demonstrated severe left ventricular systolic dysfunction with a left ventricular ejection fraction of 14%. GDMT for heart failure was initiated, alongside sustained cessation of stimulant use and multidisciplinary follow-up. Serial echocardiographic assessments over 12 months documented marked clinical and functional improvement. This case illustrates that ATSAC should be considered in young patients presenting with otherwise unexplained cardiomyopathy. Importantly, it demonstrates that significant—and potentially complete—recovery of cardiac function is achievable with early recognition, abstinence from stimulant use, and appropriate medical management. Further research is warranted to identify predictors of reversibility, clarify underlying mechanisms of myocardial injury, and develop standardized diagnostic and therapeutic strategies for ATSAC.
Abstract from DOAJ. Public domain (CC0 1.0).
Read the article at the publisher →
Kheladze, T., Shiolashvili, V., Lomidze, M., et al. (2026). Amphetamine-type Stimulant-induced Cardiomyopathy with Reversible Left Ventricular Dysfunction: A Case Report. International Journal of the Cardiovascular Academy. https://doi.org/10.4274/ijca.2026.44366