Infective Endocarditis in an Intravenous Drug User Leading to Myocardial Rupture and Hemopericardium

Area of Science:

• Cardiology
• Infectious Diseases
• Forensic Pathology

Background:

• Infective endocarditis (IE) is a serious heart lining infection that can lead to fatal complications like myocardial rupture.
• Intravenous drug use is a significant risk factor for IE, often associated with poorer health outcomes.

Purpose of the Study:

• To determine the cause of death in a young woman with a history of intravenous drug use and recent assault.
• To investigate the pathological findings of infective endocarditis and its complications.

Main Methods:

• A medicolegal autopsy was conducted on the decedent.
• Postmortem imaging, toxicology, blood cultures, and tissue cultures were performed.

Main Results:

• The cause of death was identified as myocardial rupture secondary to transmural infective endocarditis.
• Postmortem cultures identified various bacteria (Staphylococci, Streptococci) and fungi (Candida species).
• Toxicology confirmed the presence of fentanyl, methamphetamine, and cocaine metabolites.

Conclusions:

• The decedent's history of intravenous drug use and prior IE admission were significant risk factors.
• The identified microorganisms and pathological findings were consistent with infective endocarditis leading to myocardial rupture.