Pulmonary Arterial Hypertension Associated With Chronic Mephedrone Use: A Case Report.

Mephedrone is a synthetic cathinone with sympathomimetic effects, but has not previously been linked to pulmonary arterial hypertension (PAH). We report a 42-year-old woman with no prior cardiopulmonary disease who presented with severe pre-capillary PAH after a decade of near-daily mephedrone use. Extensive evaluation-including autoimmune, infectious, genetic, and imaging studies-excluded recognised causes of PAH. Following cessation of mephedrone and initiation of dual oral PAH-targeted therapy, she demonstrated substantial initial clinical and haemodynamic improvement; however, the response remained incomplete, necessitating further treatment escalation with selexipag. This appears to be the first reported case of PAH linked to mephedrone use.