heroin and Shock

A 17-year-old previously healthy girl with profound circulatory shock following a heroin overdose is reported. Except for opiates no other substances and specifically no cocaine were found in the blood and urine samples. Even though the mechanism of shock is not completely understood, severe depression of left ventricular contractility seems to be the predominant reason. Acute right heart failure with decreased pulmonary capillary wedge pressure and arterial vasodilatation resulting in maldistribution of cardiac output cannot be ruled out as possible contributing factors. The shock was successfully reversed with volume loading and a high dose of dobutamine. The recovery was uneventful and the patient was discharged with normal cardiac function.

Topics: Adolescent; Combined Modality Therapy; Drug Overdose; Emergencies; Female; Heroin; Heroin Dependence; Humans; Shock

Topics: Altitude; Animals; Capillary Resistance; Cell Membrane Permeability; Dogs; Extracellular Space; Heroin; Humans; Infant; Lung; Lymphatic System; Mechanoreceptors; Microcirculation; Microscopy, Electron; Pulmonary Alveoli; Pulmonary Edema; Pulmonary Surfactants; Shock; Substance-Related Disorders; Water-Electrolyte Balance

Topics: Altitude; Brain Injuries; Central Nervous System Diseases; Heart Failure; Heroin; Humans; Hypoxia; Pulmonary Edema; Shock; Substance-Related Disorders