Key result
Six months of total drug abstinence and optimized heart failure therapy led to complete recovery of severe toxic dilated cardiomyopathy, with ejection fraction improving from 11% to 62%.
Case Report (n=1)
No
Highlights the importance of a high index of suspicion and early intervention for potentially reversible toxic dilated cardiomyopathy induced by illicit drugs like cocaine and heroin.
Supports early intervention for suspected toxic cardiomyopathy; leaves open prospective confirmation of reversibility with abstinence.
The use of illicit drugs has increased in recent years1. Related to this increase, there is a growing need to recognise and properly treat the adverse effects associated with the consumption of these drugs. These substances can induce several cardiovascular (CV) complications, being this acute or chronic1. Some of them are the ischemic and arrhythmic events, the development of dilated cardiomyopathy (DCM) and the left ventricular systolic dysfunction (LVSD). There are several types of drugs with different pharmacological and pathophysiological properties, and synergism is described between them1. Among these, cocaine and heroin stand out. The key to a successful intervention towards one of these adverse effects is the high index of suspicion and early intervention.
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Rangel et al. (2014) conducted a case report in Toxic Dilated Cardiomyopathy (n=1). Drug abstinence and optimized heart failure therapy (beta-blockers, ACE inhibitors, diuretics) was evaluated on Recovery of left ventricular systolic function (ejection fraction). Six months of total drug abstinence and optimized heart failure therapy led to complete recovery of severe toxic dilated cardiomyopathy, with ejection fraction improving from 11% to 62%.
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