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7119737 
Journal Article 
Review 
Clenbuterol causing non-ST-segment elevation myocardial infarction in a teenage female desiring to lose weight: case and brief literature review 
Quinley, KE; Chen, HYi; Yang, HeS; Lynch, KL; Olson, KR; , 
2016 
Yes 
American Journal of Emergency Medicine
ISSN: 0735-6757
EISSN: 1532-8171 
W B SAUNDERS CO-ELSEVIER INC 
PHILADELPHIA 
34 
8 
1739.e5-1739.e7 
English 
26873408 
WOS:000380752400136 
We present a case of myocardial injury in a 17-year-old adolescent girl who took clenbuterol with the goal of losing weight. We correlated serum clenbuterol concentrations with troponin levels and patient symptoms.Vital signs, troponin, and other laboratory values were collected daily during the patient's hospitalization. After hospital discharge, serum samples were sent to the toxicology research laboratory in the Department of Laboratory Medicine at San Francisco General Hospital, where clenbuterol concentrations were determined by liquid chromatography mass spectrometry.The patient presented with flushing, diaphoresis, midsternal chest pressure, and abdominal cramping approximately 20 minutes after ingesting 4000 mu g of clenbuterol (100 times the recommended adult daily dose) as a weight loss supplement. Electrocardiogram in the emergency department demonstrated sinus tachycardia. The serum concentration of clenbuterol 7 hours post-ingestion was 5.9 ng/mL. On the second day of hospitalization, the patient's chest pain continued, and her serum clenbuterol level was 2.6 ng/mL. Electrocardiogram on hospital day 3 showed T-wave inversions in lead V-3 with nonspecific ST flattening in V-2, and the patient's first tested troponin level was 8.3 ng/mL. Serum troponin peaked at 9.0 ng/mL the following day, when concurrent clenbuterol levels were undetectable. Her troponin levels then trended downward, her chest pain resolved, and she was discharged and subsequently lost to follow-up.Clenbuterol can cause myocardial injury in young, otherwise healthy patients lacking typical cardiovascular risk factors. Our case is the first report of clenbuterol toxicity correlating serum clenbuterol and troponin levels.