Serious Heart Condition Becoming Common In Young Injection Drug Users

By Kelly Burch 04/12/18

The bacterial infection can be fatal, if left untreated.

woman holding her chest in discomfort

A serious heart infection that used to be found mostly among older adults is becoming more common in young people who inject opioids, healthcare providers report. 

Endocarditis, a bacterial infection of the valves of the heart, can be caused when bacteria is pushed into the bloodstream. This can happen when intravenous drug users don’t clean the skin of an injection site.

“Bacteria are living on your skin. Every time you inject, there's a chance of introducing bacteria into your bloodstream,” Dr. Christopher Rowley, a physician of the Infectious Disease Division at Beth Israel Deaconess Medical Center in Boston, told Fox 25 News.

With more young people injecting drugs, the rates of endocarditis are increasing among that population. In fact, one study found that hospitalizations due to endocarditis more than doubled between 2000 and 2013. 

“On any given day we have half a dozen young people who are suffering from this,” Dr. Sarah Wakeman, medical director of the Substance Use Disorder Initiative and the Addiction Consult Team at Massachusetts General Hospital.

Speaking with former Surgeon General Vivek Murthy last week, Brigham and Women's Hospital surgeon Atul Gawande said that at his Boston facility, procedures related to endocarditis have become common. 

"Right now, up in [the Shapiro building], we have more patients who are here for cardiac valve surgery for endocarditis related to drug use than we have people who are here for CABGs [a heart procedure that bypasses narrowed or blocked arteries],” he said, according to WBUR. “That is how bad it is, in our own community.”

Endocarditis can be treated with antibiotics, but it becomes more severe over time. As the condition worsens, it can require the valve surgery that Gawande mentioned. This is risky, particularly for patients whose bodies are already frail from addiction and co-occurring conditions. 

However, the biggest challenge for medical providers is that they could be performing the surgery without addressing the root cause of the infection: addiction. 

”If we don't treat the opioid use disorder which led to the infection then we've only done half the job,” said Rowley, “It could cause you to have a stroke, could lead you to have heart failure.” 

Ultimately, like addiction, endocarditis can be fatal if left untreated. Cheryl Molloy-Emerson's younger sister, Tina, died at age 31 after developing endocarditis after years of injecting heroin. Tina had been having symptoms, but by the time she was hospitalized and ultimately put on a respirator, it was too late. 

“She had been complaining about the chest pain, the swelling in her legs. Her hair was falling out. She'd start crying,” Molloy-Emerson said. “There was just so much potential that was lost."

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.