Pulmonary vascular complications in narcotic addicts

Perfusion deficits on lung scanning in narcotic addicts are frequently demonstrable. To determine the angiographic and hemodynamic correlates of these deficits, right heart catheterization with selective pulmonary angiography was carried out in 7 addicts with abnormal lung scans, and one with normal scan. Four had angiographic abnormalities corresponding to the regions of perfusion defects on lung scan. These consisted of large vessel cut-offs, intraluminal filling defects and/or considerably reduced vascularity. Three subjects had normal angiograms in the presence of abnormal perfusion scans. One subject had normal angiogram and scan. All eight patients had normal pulmonary artery pressures and calculated pulmonary vascular resistances. This study demonstrates that (1) angiographic abnormalities in larger pulmonary arteries may be found in narcotic addicts with perfusion defects on lung scanning, and (2) these findings may be present without significant hemodynamic alterations.