An otherwise healthy 28-year-old man had a cardiac arrest after a day of motocross racing. He had consumed excessive amounts of a caffeinated “energy drink” throughout the day. We postulate that a combination of excessive ingestion of caffeine- and taurine-containing energy drinks and strenuous physical activity can produce myocardial ischaemia by inducing coronary vasospasm.
A 28-year-old male amateur motocross rider was admitted to Port Macquarie Base Hospital in August 2007 after having an out-of-hospital cardiac arrest. He had collapsed shortly after participating in a motocross race. An off-duty paramedic and nurse had been on hand, and effective cardiopulmonary resuscitation was commenced promptly. Paramedics arrived after about 20 minutes of resuscitation.
- 1. Drory Y, Turetz Y, Hiss Y, et al. Sudden unexpected death in persons less than 40 years of age. Am J Cardiol 1991; 68: 1388-1392.
- 2. Eckart RE, Scoville SL, Campbell CL, et al. Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med 2004; 141: 829-834.
- 3. Wever EF, Robles de Medina EO. Sudden death in patients without structural heart disease. J Am Coll Cardiol 2004; 43: 1137-1144.
- 4. Lange RA, Hillis LD. Cardiovascular complications of cocaine use. N Engl J Med 2001; 345: 351-358.
- 5. CBC News. In the can: Red Bull’s ingredients dissected. http://www.cbc.ca/consumers/market/files/health/redbull/ingredients.html (accessed Jan 2008).
- 6. Australia New Zealand Food Authority. Inquiry report. Application A394: formulated caffeinated beverages. 8 August 2001. http://www.foodstandards.gov.au/_srcfiles/A394_(full)_report.pdf (accessed Jan 2008).
- 7. Haller CA. Caffeine. In: Olson KR, editor. Poisoning and drug overdose. International ed. The McGraw-Hill Companies, 2007.
- 8. Mehta A, Jain AC, Mehta MC, Billie M. Caffeine and cardiac arrhythmias. An experimental study in dogs with review of literature. Acta Cardiol 1997; 52: 273-283.
- 9. Steele DS, Smith GL, Miller DJ. The effects of taurine on Ca2+ uptake by the sarcoplasmic reticulum and Ca2+ sensitivity of chemically skinned rat heart. J Physiol 1990; 422: 499-511.
- 10. Watanabe C, Yamamoto H, Hirano K, et al. Mechanisms of caffeine-induced contraction and relaxation of rat aortic smooth muscle. J Physiol 1992; 456: 193-213.
- 11. Holmgren P, Nordén-Pettersson L, Ahlner J. Caffeine fatalities — four case reports. Forensic Sci Int 2004; 139: 71-73.
- 12. Cannon ME, Cooke CT, McCarthy JS. Caffeine-induced cardiac arrhythmia: an unrecognised danger of healthfood products. Med J Aust 2001; 174: 520-521. <MJA full text>
- 13. Organisation for Economic Co-operation and Development. SIDS [Screening Information Data Set] initial assessment profile: caffeine. Paris: OECD, Mar 2002. http://www.chemicals.moew.government.bg/chemical/site/File/registers/profile/58082p.pdf (accessed Jan 2008).
- 14. Forman J, Aizer A, Young CR. Myocardial infarction resulting from caffeine overdose in an anorectic woman. Ann Emerg Med 1997; 29: 178-180.
- 15. Baum M, Weiss M. The influence of a taurine containing drink on cardiac parameters before and after exercise measured by echocardiography. Amino Acids 2001; 20: 75-82.
- 16. World Anti-Doping Agency. The 2008 Monitoring Program. http://www.wada-ama.org/rtecontent/document/Monitoring_Program_2008_En.pdf (accessed Oct 2008).
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