Cardiovascular and pulmonary complications of recreational drugs: A pictorial review

Eur J Radiol. 2024 Sep:178:111648. doi: 10.1016/j.ejrad.2024.111648. Epub 2024 Jul 23.

Abstract

Recreational drug abuse constitutes a serious health problem worldwide. Consumption of cocaine, amphetamine-type stimulants, opioids and cannabis can lead to multiple acute and chronic cardiopulmonary complications, resulting in high morbidity and mortality. These complications may be first detected at imaging, since clinical presentation is usually non-specific. Cardiovascular complications include myocardial infarction, endocarditis, aortic dissection, infectious pseudoaneurysm, retained needle fragments, cardiomyopathy and pulmonary arterial hypertension. Pulmonary complications encompass pulmonary oedema, crack lung, pneumonia, septic emboli, barotrauma, airway disease, emphysema and excipient lung disease. Knowledge of the cardiopulmonary imaging manifestations of illicit drug use in conjunction with clinical history and a high grade of suspicion enable an accurate diagnosis and appropriate management plan. In this article we aim to provide a pictorial review of the most frequent cardiopulmonary manifestations of recreational drugs, emphasizing the underlying pathophysiologic mechanisms and the various imaging appearances.

Keywords: Cardiovascular complications; Illicit drug abuse; Pulmonary complications; Recreational drug abuse.

Publication types

  • Review

MeSH terms

  • Cardiovascular Diseases / chemically induced
  • Cardiovascular Diseases / diagnostic imaging
  • Humans
  • Illicit Drugs* / adverse effects
  • Lung Diseases* / chemically induced
  • Lung Diseases* / diagnostic imaging
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / diagnostic imaging

Substances

  • Illicit Drugs