Myocardial injury after phenylpropanolamine ingestion.

Three patients developed clinical evidence of myocardial injury after acute ingestion of phenylpropanolamine, a sympathomimetic amine found in a large number of decongestant and appetite suppressant formulations. Increases in the serum creatine kinase and MB isoenzyme levels, ventricular arrhythmias, and electrocardiographic repolarisation abnormalities were seen. Excessive catecholamine stimulation has been shown to produce acute myocardial necrosis experimentally, and a similar mechanism may be present in these patients.