Sympathomimetic Overdose With Lisdexamfetamine in a Pediatric Patient Resulting in Stress Cardiomyopathy—A Case Report

BACKGROUND: Sympathomimetic overdoses, as seen in amphetamine ingestions, are known to have cardiac effects ranging from tachycardia and hypertension to coronary vasospasm and myocardial infarction. Stress cardiomyopathy is rare in pediatric patients and has not been reported in association with the extended-release preparation of lisdexamfetamine, indicated for the treatment of attention-deficit hyperactivity disorder. CASE SUMMARY: A 17-year-old girl presented with an intentional ingestion of lisdexamfetamine and signs and symptoms of a sympathomimetic toxidrome. She was found to have severe cardiac dysfunction, which worsened within 24 hours of ingestion and required intubation and management of acute heart failure. CONCLUSIONS: Stress cardiomyopathy due to extended-release stimulant ingestion is a possible outcome of intentional ingestion. Providers should be vigilant and monitor for signs of cardiac dysfunction.