Drugs and congenital heart defects
Narcotics, nicotine and alcohol
Whether we like it or not, alcohol, tobacco and, in some cases, illegal drugs are a part of life, and many people use them despite the known health risks. For those with a congenital heart defect, the risks are even greater, especially if they smoke. Nicotine, found in tobacco, increases the risk of cardiovascular disease and causes cancer. On the other hand, moderate alcohol use is not dangerous, unless you are taking warfarin.
Be careful
People with congenital heart defects suffer the same negative effects of nicotine and narcotics on the heart as the rest of the population, but they should be extra careful, as drugs can be even more dangerous if your heart is already stressed.
Most of us are able to limit ourselves to moderate consumption of, for instance, alcohol, without becoming abusers. However, there is no safe consumption level with cigarettes. Smokers run a greater risk of developing acquired cardiovascular disease, but if they stop smoking, they can lower the risk. In other words, you can influence your own situation.
Talk with your cardiologist
If you are unsure about the specific consequences of your particular heart defect, you should talk with your cardiologist or with a specialist nurse. Ask questions and share your concerns, even if you are using illegal drugs or are worried that you drink too much. Choose someone that you trust to talk to, and remember that healthcare personnel have your best interests at heart. They can also refer you to a social welfare officer or psychologist if you need help in breaking an abusive habit, or if you are using alcohol or drugs to relieve anxiety and unrest.
What is a drug?
A drug is generally defined as any substance that is mind-altering and/or addictive. The definition can, however, differ somewhat between countries and cultures. The present text is concerned mainly with narcotics, nicotine and alcohol, but it also includes information about other drug abuse, such as sniffing fumes and GHB abuse. It is usually during our teenage years that most of us come into contact with illegal drugs. The main drugs teenagers use are nicotine and alcohol. When it comes to narcotics, cannabis is the most commonly used.
Narcotics do not affect just the brain (and therefore our vision, hearing and sensory impressions), they also affect the heart, and that can be fatal for those with congenital heart defects. Injecting narcotics increases the risk of endocarditis.
| Type of drug | How it works |
|---|---|
| Alcohol | Long-term alcohol consumption can raise the blood pressure and cause heart failure. Alcohol abuse can also lead to arrhythmias and, in some cases, cardiomyopathy. Pain pills combined with alcohol can result in intoxication. If you are taking warfarin, you should abstain from drinking alcohol. |
| Amphetamine and crystal meth | Amphetamine is also bad for the heart: the heart rate increases, as does blood pressure and the risk of arrhythmias and stroke. Amphetamine abuse also raises the risk of pulmonary oedema. |
| Anabolic steroids | Abuse of anabolic steroids can cause arteriosclerosis and thickening of the heart muscle. |
| Cannabis | Cannabis increases the heart rate and affects the blood pressure. It also affects your heart and general health in the same way as regular cigarettes. The risk of becoming dependent on cannabis is lower than for cocaine, heroin or amphetamine. |
| Cocaine | Cocaine increases the heart rate and blood pressure. It also increases the risk of blood clots and stroke. Cocaine abuse raises the risk of arrhythmias and can lead to heart failure. It also increases the QT interval, which means it should be avoided by people with Long QT Syndrome (LQTS) in particular and can cause myocarditis, inflammation of the heart muscle. Cocaine users may also develop cardiomyopathy, a condition in which the heart muscle has become damaged. There have also been cases where young people have suffered heart attacks after taking cocaine. Cocaine is extremely addictive, and long-term use can result in irritation or even paranoia. |
| Ecstasy | Ecstasy is a central stimulant similar to amphetamine and the hallucinogenic drug mescaline. Large doses of ecstasy cause palpitations and high blood pressure. Ecstasy can also cause arrhythmias, especially in combination with amphetamine. Those who take ecstasy run a risk of becoming depressed in subsequent stages. Ecstasy does not appear to be extremely addictive. |
| GHB | GHB is a power anaesthetic of variable strength. This makes it difficult to determine the dosage and overdoses are not uncommon. GHB lowers the heart rate and breathing frequency, and users run the risk of fatal respiratory arrest. GHB also spurs the body on and causes aggressiveness that can lead to ill-considered actions. |
| Hallucinogenic drugs | Mescaline, LSD and other hallucinogenic drugs increase cardiac activity and raise the blood pressure. LSD can also be powerfully anxiety-inducing. |
| Heroin | In contrast to the narcotics described above, heroin and other opiates lower the heart rate and can, in the worst cases, cause cardiac arrest. They can also cause respiratory problems or pulmonary oedema. Heroin binds to special opiate receptors in the brain. The consequence is dependence on regular stimulation of the brain's reward centre. |
| Ketamine | Ketamine is another powerful anaesthetic that is used in surgery. It elevates the heart rate and blood pressure. |
| Nicotine | Nicotine is one of the greatest threats to health and increases the risk of cardiovascular disease. With the first puff, you can feel your heart racing and beating faster. Nicotine can raise blood lipid levels, obstruct small blood vessels, and cause heart attacks. It also degrades the circulation of blood. Smokers are also at risk of developing blood clots. Nicotine causes withdrawal symptoms that create a restlessness that is relieved by more nicotine. |
| Poppers | Poppers are small vials that contain chemicals that dilate the blood vessels. This brings more blood to the heart, causing blood pressure to drop. Poppers are especially dangerous for people with heart defects or high blood pressure, and for those taking heart medicines that contain nitrates. |
| Sniffing fumes | Sniffing fumes from, for instance, lighter fluid affects the body's production of adrenalin, which disrupts the heart rhythm and can lead to cardiac arrest. Sniffing fumes has led to cardiomyopathy on rare occasion. |
References
Hearts4Teens (Children's heart association) http://www.hearts4teens.org.uk/crucialinformation/lifestyle.htm, accessed on 12/02/2008
Young Hearts, http://www.yheart.net/yheart/default.aspx?page=3, accessed on 12/02/2008
Talk to Frank, www.talktofrank.com, accessed on 12/02/2008
Central Association for Alcohol and Narcotics Information www.drugsmart.com, accessed on 12/02/2008
Raphael Zahler, MD, PhD Caroline Piselli, RN, MBA Yale University School of Medicine Heart Book, Chapter 6 Smoking, alcohol and drugs, 2002
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