heroin and Cardiomyopathies

Topics: Adult; Amphetamine; Cardiomyopathies; Cocaine; Drug Synergism; Electrocardiography; Female; Heroin; Humans; Male; Methylphenidate; Middle Aged; Substance-Related Disorders; Time Factors

Topics: Analgesics, Opioid; Cardiomyopathies; Heroin; Humans; Ischemic Preconditioning; Morphine

We report a case of biopsy proven myocardial damage after opiate-induced rhabdomyolysis. Myocardial biopsy showed focal lesions formed by small mononuclear inflammatory cells with a few neutrophils, associated with degenerated and necrotic myocardial fibers, interstitial edema and congestion of intrinsic blood vessels. These findings were similar to those seen with other drug overdoses if combined with strenuous muscular effort or hypoxic coma. We hypothesize that myocardial damage is a consequence of intracapillary myohypoxia associated with prolonged hypoxic coma following opiate overdose.

Topics: Adult; Biopsy; Cardiomyopathies; Cell Hypoxia; Coma; Drug Overdose; Heart; Heroin; Humans; Male; Myocardium; Narcotics; Necrosis; Rhabdomyolysis

Eight young addicts developed rhabdomyolysis as a complication of heroin overdose. ECG, plasma enzyme time activity curves and thallium myocardial scintigraphy were highly suggestive of a myocardial lesion associated with rhabdomyolysis. Such changes were particularly striking in 3 patients with acute left ventricular failure, as shown by a hemodynamic investigation (3 patients) and by echocardiography (1 patient). All patients recovered but myocardial scintigraphy and ECG remained abnormal for a period ranging from 8 months to 3 years following the acute episode. Although associated metabolic changes may play a role in myocardial dysfunction, the most likely mechanism appears to be a direct toxic effect of heroin on cardiac muscle.

Topics: Adult; Cardiomyopathies; Electrocardiography; Heart; Heroin; Heroin Dependence; Humans; Male; Radioisotopes; Rhabdomyolysis; Thallium

A case of acute left ventricular failure following an intravenous dose of amphetamine is described. The diagnosis was made by right heart catheterization. This is the first description of acute amphetamine cardiomyopathy in the medical literature.

Topics: Acute Disease; Adult; Amphetamine; Cardiomyopathies; Catheterization; Heroin; Humans; Male; Pulmonary Edema; Substance-Related Disorders