Injecting illicit substances epidemic and infective endocarditis

Area of Science:

• Cardiology
• Infectious Diseases
• Public Health

Background:

• Infective endocarditis (IE) is a critical concern in intravenous drug abusers (IVDAs).
• While historically associated with right-sided heart valves, left-sided IE is increasingly reported in this population.
• Despite advances in imaging, understanding right-sided IE in IVDAs requires further attention.

Purpose of the Study:

• To comprehensively review the epidemiology, predisposing factors, clinical features, complications, diagnosis, treatment, and prognosis of IE in IVDAs.
• To highlight distinctive and exclusive features of IE in individuals who inject illicit substances.
• To provide an updated perspective on this serious condition.

Main Methods:

• Literature review of published reports on IE in IVDAs.
• Synthesis of information regarding epidemiological trends.
• Analysis of clinical presentations, diagnostic modalities, and therapeutic strategies.

Main Results:

• Right-sided endocarditis constitutes approximately 10% of all IE cases and is strongly linked to illicit drug injection.
• An increasing trend of left-sided valve involvement in IE among IVDAs has been observed.
• Despite improved diagnostic capabilities, challenges remain in fully understanding right-sided IE.

Conclusions:

• IE remains a significant risk for IVDAs, necessitating high clinical suspicion.
• The evolving patterns of IE, including increased left-sided valve involvement, require ongoing vigilance.
• A comprehensive understanding and tailored management approach are crucial for improving outcomes in this patient group.