Intravenous Drug Use Tied to Alarming Rise in Fatal Heart Valve Infections


A study of death records from 1999 to 2020 shows a link between using drugs through an IV and dying from infective endocarditis.

A condition called endocarditis makes the walls of the heart swell up.

One of the experts on the study, Dr. Sudarshan Balla of WVU Medicine, said that the analysis showed a general trend in the number of deaths from endocarditis during that time. “Overall, we found that the number of deaths from this infective endocarditis was going down,” Balla said.

He said that things got a little trickier when they looked at the numbers more closely. Balla said that the number of deaths from infective endocarditis stayed the same or went down in most states, but that the number of deaths rose in a few states.

He said, “West Virginia, Kentucky, Tennessee, and I think a little bit of Mississippi as well.”

For people ages 25 to 44, the study found that deaths were especially high in these states. Balla said that many of the people who died had one thing in common besides endocarditis, which is always fatal.

Bala said, “When we looked at it, it looked like most of these people who were dying from infective endocarditis also had a diagnosis of substance use disorder on their death certificates.”

Balla says that the rise in dangerous infections is probably due to more people using drugs through IVs. “When people inject drugs into their veins, bacteria can get right into their bloodstream,” he said. This is how the germs that get into the blood can grow and infect the heart valves.

Balla said that more study is needed to fully understand what other things might be causing more people to die from infective endocarditis.

He did say, though, that the link he and his colleagues found between the deaths and substance abuse problem might change how doctors treat infective endocarditis.

Balla said, “a multiple team approach that includes the infectious disease doctors, the heart doctors, the heart surgeons, and the behavioral health doctors would be best for this group of patients.”

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