Apical regional wall motion abnormalities reminiscent to Tako-Tsubo cardiomyopathy following consumption of psychoactive fungi.

A young man experienced an acute coronary syndrome with ST-elevation after consuming psychoactive fungi ("magic mushrooms"). Coronary angiography found no significant coronary artery disease, but ventriculography showed contractile dysfunction with apical hypokinesia resembling Tako-Tsubo cardiomyopathy. Cardiovascular magnetic resonance imaging ruled out myocardial infarction or inflammation. Ventricular function normalized within days. The active metabolite psilocybin interacts with dopaminergic, adrenergic, and serotonergic receptors, suggesting pathomechanisms similar to those in Tako-Tsubo cardiomyopathy.

Study at a glance

Abstract

Consumption of natural hallucinogenic substances continues to be a problem. In this case we report from a young male patient presenting with an acute coronary syndrome with significant ST-elevation after the abuse of psychoactive fungi, commonly referred to as "magic mushrooms". Coronary angiography excludes relevant coronary artery disease. In ventriculography contractile dysfunction with hypokinesia in the apical segments could be documented reminiscent to wall motion abnormalities in Tako-Tsubo cardiomyopathy (TTC). Cardiovascular magnetic resonance imaging showed no pathological signal activity in the late-enhancement sequences ruling out myocardial infarction or inflammatory processes. Ventricular function normalized within several days. The active metabolite of psychoactive fungi psilocybin is known to interact with several different dopaminergic, adrenergic and serotonergic receptors. Thus, the pathomechanisms leading to contractile dysfunction after consumption of psychoactive fungi are reminiscent to those documented in TTC.