Myocardial Infarction After Energy Drink Overconsumption in Adolescents and Young Adults: Mechanistic Vulnerability in Strength Athletes, Extreme Dieters and Other High-Risk Groups

Energy drink consumption is common among adolescents and young adults who use these products for perceived improvements in energy, alertness and athletic performance.Case reports and experimental studies suggest that high volume intake may precipitate myocardial infarction and related acute coronary syndromes, including in individuals without traditional cardiovascular risk factors.Available evidence supports several biologically plausible pathways, including sympathoadrenal activation with increased myocardial oxygen demand, impaired coronary perfusion reserve with vasomotor dysfunction, prothrombotic signalling through platelet activation and endothelial impairment and electrophysiologic instability with QTc prolongation and arrhythmia mediated ischemia.This review synthesizes published cases and human physiologic studies and highlights subgroups with heightened vulnerability.These include strength athletes who use anabolic androgenic steroids or combine stimulants around training, individuals engaging in extreme dietary restriction or rapid weight cutting, patients with eating disorder behaviours that produce dehydration and electrolyte abnormalities and individuals exposed to sleep deprivation or heat stress that can intensify hemodynamic strain and hypercoagulability.Additional risk amplification may occur with alcohol or sympathomimetic co ingestion and in individuals with occult channelopathies or baseline endothelial susceptibility.Current evidence suggests that energy drink overconsumption can act as an acute trigger for myocardial infarction in susceptible individuals.Prospective studies are needed to define exposure thresholds, clarify ingredient interactions and identify which populations are most at risk.