Characteristics of the group of drug-addicted patients with infectious endocarditis

Late diagnosis of infectious endocarditis in drug-dependent patients is not only the cause of an unfavorable outcome, but also the delayed provision of surgical care. The literature contains isolated publications on the surgical treatment of infectious endocarditis in these patients. In this regard, it is of interest to study and systematize demographic, anamnestic, clinical and instrumental data to determine the optimal amount of surgical intervention and predict the course of the early postoperative period. The aim. To study demographic, anamnestic, clinical and instrumental data of drug-addicted patients with infectious endocarditis. Materials and methods. A retrospective analysis of the data of 25 drug-dependent patients with infectious endocarditis who were treated at the Federal State Budgetary Institution Federal Center for Cardiovascular Surgery of the Ministry of Health of the Russian Federation (Astrakhan) from 2019 to   2023 was carried out. Results. The median age of the patients was 37,0 [29,0; 47,0] years. Male patients predominated over females. In their medical history, 100,0 % of the patients had chronic viral hepatitis C, with 12,0 % having it in combination with hepatitis B; 32,0 % had arthralgia; and 24,0 % each had iron-deficiency anemia, bilateral polysegmental pneumonia, liver cirrhosis, and hepatomegaly. Tuberculosis of the lungs was present in 12,0 % of cases, while hepatorenal failure and portal hypertension were observed in 8,0 % of patients each. Complications of infective endocarditis included meningoencephalitis in 16,0 % of patients, sepsis in 20,0 % of patients, and pulmonary embolism in 24,0 % of patients. The infective endocarditis was primary and had a subacute course. Clinical manifestations of infective endocarditis included fever, weakness, fatigue, weight loss, arthralgia, and pulmonary embolism; no peripheral signs of the disease (such as rash) were detected. Instrumental findings of infective endocarditis included vegetations and regurgitation on the heart valves; in 40,0 % of cases, there was isolated involvement of the tricuspid valve. Conclusion. Drug-dependent patients with infectious endocarditis had polymorbid pathology, which was accompanied by immune disorders (HIV, hepatitis, iron deficiency anemia) and could affect the outcome of infectious endocarditis, which requires further study.

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