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Intravenous drug abuse led to infective endocarditis, causing stroke-like symptoms and multiple organ emboli. This case highlights the severe cardiovascular complications linked to drug use and endocarditis.

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Area of Science:

  • Cardiology
  • Neurology
  • Toxicology

Background:

  • Intravenous drug abuse (IVDA) is a significant public health concern.
  • Infective endocarditis is a serious complication associated with IVDA.
  • Stroke-like symptoms can arise from various underlying pathologies.

Observation:

  • A 37-year-old woman with a history of IVDA presented with extremity weakness and pain.
  • Autopsy revealed extensive endocardial vegetations on the tricuspid and mitral valves and a patent foramen ovale.
  • Embolization of vegetations led to blockages in the lungs, liver, and brain, including bilateral middle cerebral arteries.

Findings:

  • The cause of death was infective endocarditis with widespread septic emboli.
  • Acute embolization to the middle cerebral arteries mimicked a stroke.
  • Comorbidities included cardiomegaly, myocardial infarction, and atherosclerotic disease.

Implications:

  • This case underscores the critical link between IVDA, endocarditis, and cerebrovascular events.
  • Understanding these complex interactions is vital for accurate diagnosis and treatment of patients with similar presentations.
  • Findings serve as a reference for forensic pathology and clinical management in the context of the ongoing opioid crisis.