Cardiac Complaints Encountered After Use of Street Drugs: A Review of their Cardiac Toxicity Mechanism

Abstract

Objectives: The upward trend leading to versatility in street drug (SD) usage paves the way to numerous complications to organ systems, including cardiovascular events. But, findings on cardiac complications, as well as their prevalence and survey from SD abusers are not encountered in the literature.
Material and Methods: In this survey study, patients admitted to the emergency department (ED) with suspected substance abuse were collected prospectively and cardiac complications were observed. The relationship between variables and all types of SDs were analyzed. Prevalance of the cardiovascular events were calculated. Also, uncommon cardiovascular events after SD use were defined.
Results: In a total of 425 (424 male, 98.4%) participants, cardiac complaints after substance use were noted in 14.6% (n=62). High degree AV-node conduction block secondary to synthetic cannabis, and moreover occlusive ST segment elevated myocardial infarction (STEMI) after cannabis use was identified. In other 2 cases, ecstasy use was associated with both STEMI and tachycardia.
Conclusion: Emergency physicians and cardiologist must be competent in the management of patients with substance abuse and potential novel cardiac complications. Especially young males with substance use and suspicious presentations such as syncope, palpitation, and vomiting complaints may be at risk. Cardiac complications on rhythm disturbance, conduction delay or obstructive myocardial infarct can become other than in literature.