MSMC Case Study Examines Potential Relationship Between Consumption of Energy Drinks and Heart Attacks

A case study from Mount Sinai Medical Center in Miami Beach, Florida examines the potential relationship between heart attacks and energy drink intake. The study was recently published in the American Heart Association’s publication, Circulation. (Circulation 2012, 125:1447-1448)

A 24-year old, previously healthy male presented himself to the Mount Sinai Emergency Room with a 10-hour history of nausea, palpitations and severe chest pain described as constant pressure. His symptoms begin approximately one to two hours after having consumed three vodka and energy drink cocktails. The subject had no prior history or family history of heart disease and, tests concluded that he had no other forms of recreational or prescription drugs in his system.

Upon admission, his initial electrocardiogram (ECG) showed normal sinus rhythm. However, upon repeating the test, the subject showed a rapid ST elevation, which signifies a blockage of a coronary artery most commonly caused by a thrombus or an embolus. He was taken into the cardiac catheterization laboratory where the diagnosis was made. A large clot was seen in the main coronary of the heart. The patient developed congestive heart failure and was taken into surgery where a coronary bypass graft surgery was ultimately performed.

The patient recovered well and all further laboratory tests, including a lipid profile and coagulation panel, were within normal limits. The patient was discharged home on warfarin, an anticoagulant used to prevent blood clots.

Though the case study cannot conclude that the mixture of alcohol and energy drinks was, indeed, the cause of this patient’s heart failure, it also cannot be ruled out as it was the only variable present that was outside of his norm.

“Though this case study does not conclude that consumption of energy drinks cause heart attacks, we cannot ignore that this was the only variable that was different in this young patient’s routine,” said Dr. Esteban Escolar, cardiology at Mount Sinai and one of the study’s authors. “In fact, there are several other published studies that have recorded a possible correlation between energy drinks and cardiac issues. Once our study is compiled with the others, they begin to show a trend that cannot be ignored and must be investigated further.”

Previous case reports have linked energy drinks with sudden cardiac death, coronary vasospasm, reversible postural tachycardia syndrome, and serious arrhythmias, including ventricular fibrillation. A recently published article in the American Journal of Medicine demonstrated that 250 mL of energy drink can acutely cause endothelial dysfunction and significantly increase platelet aggression. Almost all such commercially available drinks have the same basic stimulants – caffeine, glucoronolactone, taurine, and vitamins – and it is difficult to know which component besides caffeine, which has been ruled out, is responsible for the effect in platelet aggregation and endothelial function. Although its function is not clear, taurine has been found in high concentrations in platelets.

Consuming energy drinks and mixing them into cocktails has become increasingly popular. In 2007, 51% of college students had consumed at least one energy drink in the prior month and, 54% of those had mixed it with alcohol.

This Mount Sinai case study shows that the effects of energy drink needs to be scrutinized because of their increasing consumption by the public and their potentially lethal effects.

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