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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
PubMed

Insights

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.

Keywords:
Left ventricular thrombusMyocarditisVentricular assist device

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