The rise in abuse of methamphetamine is a serious concern today. This paper explores possible connections between methamphetamine abuse and heart disease. Methamphetamine's increase of catecholamine levels causes an acute increase in cardiac stress, tone, and platelet aggregation. This may lead to vascular occlusion, rupture of coronary lesions, vasoconstriction, infarction, or dilated cardiomyopathy. Hypertension and tachycardia might promote aneurysms or aortic dissection. In experimental situations, methamphetamine causes myocardial hypertrophy, atrophy, cellular disarray, edema, eosinophilic degeneration, cellular infiltration, myolysis, granulation tissue, and fibrosis. Upon cessation of methamphetamine use, most of these conditions will reverse with time. However, fibrosis will not reverse itself. Methamphetamine also damages microtubular and actin cellular structures with prolonged use. Noncardiac complications are briefly discussed. This paper also includes a review of amphetamine and 3,4-methyl-enedioxymethamphetamine ("ecstasy"), noting that they have similar effects on the heart. Diagnosis and treatment are also described. More research is needed to evaluate the many potential actions that methamphetamine has on the heart.