Association of recreational drug consumption, cardiac toxicity and heart transplantation

Association of recreational drug consumption, cardiac toxicity and heart transplantation

Can J Surg 2019;62(5):356-357 | PDF

Michel Carrier, MD, MBA; Geneviève Giraldeau, MD; Marie-Claude Parent, MD, MSc; Anique Ducharme, MD, MSc

Summary

Cardiac toxicity from recreational drug use remains difficult to establish. We report the cases of 3 young patients who were hospitalized for cardiogenic shock. All were bridged to transplantation with implantation of a left ventricular assist device (LVAD). They underwent uneventful heart transplantation. The patients did not have any significant personal or family medical history, but all admitted consuming large quantities of recreational drugs daily. Histological examination of the native heart did not show any inflammation or infiltrative myocardial disease. In this series of young patients presenting in cardiogenic shock with minimal histologic findings on examination of the native hearts, the association between cardiac toxicity and active use of recreational drugs remains a strong possibility. The transplant community should be made aware of this possible association in the current era of legalization and social trivialization of drug consumption.


Accepted Sept. 28, 2018

Affiliations: From the Department of Cardiac Surgery, Montreal Heart Institute and Université de Montréal, Montreal, Que. (Carrier); and the Department of Medicine, Montreal Heart Institute and Université de Montréal, Montreal, Que. (Giraldeau, Parent, Ducharme).

Competing interests: A. Ducharme has received speaker fees from Abbott, AstraZeneca, Merck, Novartis and Servier; research support from Novartis, Pfizer and Servier; and sits on the advisory boards of Akcea, Amgen, Novartis and Servier. No other competing interests declared.

Contributors: All authors contributed substantially to the conception, writing and revision of this article and approved the final version for publication.

DOI: 10.1503/cjs.011018

Correspondence to: M. Carrier, Department of Cardiac Surgery, Montreal Heart Institute, 5000 Belanger St, Montreal QC H1T 1C8, michel.carrier@icm-mhi.org