Related Experiment Video
Updated: Aug 2, 2026
07:27
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Severe Heart Failure in a Young Cocaine User
Norifumi Bekki1, Hiromasa Hayama1, Rina Ishii2
1Department of Cardiology, National Center for Global Health and Medicine.
International Heart Journal
|November 8, 2021
Summary
Cocaine use can cause severe heart failure and left ventricular thrombus in young adults. Early recognition and intervention, including mechanical support, are crucial for managing this drug-induced cardiovascular toxicity.
Area of Science:
- Cardiology
- Toxicology
- Internal Medicine
Background:
- Recreational drug use, including cocaine, is a growing global concern.
- Cocaine use is associated with various cardiovascular complications.
- Young individuals with unexplained heart failure require comprehensive etiological investigation.
Observation:
- A 27-year-old male with asthma presented with severe heart failure and left ventricular thrombus.
- Transthoracic echocardiography revealed severe left ventricular hypokinesis and a large mobile thrombus.
- Despite initial medical management, the patient remained inotrope-dependent, necessitating mechanical circulatory support.
Findings:
- The patient's condition was attributed to cocaine-induced cardiotoxicity.
- Left ventricular assist device (LVAD) implantation and surgical thrombus removal were required.
- This case highlights a severe manifestation of drug-induced heart failure.
Implications:
- Clinicians should consider illicit drug use in young patients presenting with cardiovascular disease, even in regions with strict drug laws.
- Prompt diagnosis and management of cocaine-induced cardiomyopathy are essential to improve patient outcomes.
- Raising awareness about the cardiovascular risks of recreational drugs is critical for public health.
Related Concept Videos
01:26Heart Failure Drugs: Inotropic Agents
Positive inotropic agents are commonly used as the first line of treatment for heart failure. One such agent is digoxin, derived from the genus Digitalis, which has been known for centuries but effectively utilized since 1785. However, these cardiac glycosides can have potentially toxic effects due to their mechanism of action, which involves inhibiting Na+/K+-ATPase and increasing contractility. Digoxin is absorbed orally and distributed in various tissues, including the CNS. It has a long...
01:24Drug Toxicity: Risk factors
Adverse Drug Reactions (ADRs) are potential complications that arise during pharmacotherapy, influenced by multiple risk factors. Age plays a significant role; both neonates and the elderly are at heightened risk due to their respective immature and diminished metabolic and elimination processes. Gender also impacts ADRs, with females experiencing a 1.5 to 1.7-fold greater risk than males, which may be linked to pharmacokinetic, pharmacodynamic, and hormonal differences. Notably, neonates, the...
01:27Heart Failure I: Introduction
Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
01:29Heart Failure II: Pathophysiology
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
01:26Heart Failure III: Clinical Manifestations
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
01:30Heart Failure V: Medical Management
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...