Doctor Tran Thi Huyen Trang, from Tam Anh Cau Giay General Clinic, stated that while drugs affect the nervous and mental systems, the cardiovascular system is among the first and most severely damaged organs.

Doctor Megan Ritson of Cambridge University analyzed medical data from over 100 million people, published in The Guardian in march, showing that drug use can double the risk of stroke. This study noted that amphetamine users had a 122% increased risk of stroke compared to non-users.

Another study by the University of California, published in the Journal of the American Heart Association in 2022, analyzed data from over 20.2 million people in California, including 66,200 methamphetamine users. Methamphetamine users had a 32% higher risk of cardiovascular disease, a 53% increased risk of heart failure, and a 42% increased risk of pulmonary hypertension compared to non-users.

Causes high blood pressure, coronary artery spasm, myocardial infarction

Stimulants such as cocaine, methamphetamine, and MDMA significantly increase the activity of the sympathetic nervous system. This leads to a rapid heart rate, a sudden surge in blood pressure, and abrupt coronary artery spasm. Even without atherosclerotic plaque in the coronary arteries, users can still experience acute myocardial infarction. This occurs due to coronary artery spasm, which increases myocardial oxygen demand while severely reducing the blood supply to the heart, creating a dangerous "oxygen starvation."

Arrhythmias

Stimulant drugs disrupt the heart's electrical conduction system. Users may experience premature beats, atrial fibrillation, ventricular tachycardia, and ventricular fibrillation – arrhythmias capable of causing sudden death within a few minutes.

With methamphetamine and cocaine, the risk of arrhythmias increases due to a sudden surge in catecholamine levels in the blood, causing the heart to overwork, which can lead to immediate sudden death, even in young drug users with no prior cardiac history.

Doctor Trang examines a patient's heart and advises on lifestyle changes. *Photo: Tam Anh Cau Giay General Clinic*

Infective endocarditis

A specific complication in intravenous drug users is infective endocarditis. Bacteria from contaminated needles enter the bloodstream, adhere to heart valves, particularly the tricuspid valve in the right heart, forming an infection site.

Patients often experience prolonged fever, fatigue, shortness of breath, and hemoptysis as vegetations break off and travel to the lungs, causing septic embolism. Treatment typically involves many weeks of strong antibiotics, and sometimes requires heart valve replacement surgery.

Dilated cardiomyopathy and chronic heart failure

Prolonged drug use, especially methamphetamine, directly damages cardiomyocytes. The heart gradually dilates, its walls thin, and its contractility decreases – leading to dilated cardiomyopathy.

Patients develop shortness of breath, leg swelling, fatigue, enlarged liver, and pleural effusion – typical signs of heart failure. This damage is often not fully reversible, even after stopping drug use.

Cerebral stroke due to high blood pressure and embolism

Hypertensive crisis, arrhythmias, and a hypercoagulable state from drug use significantly increase the risk of cerebral stroke. Users are prone to hemorrhagic stroke due to ruptured vessels when blood pressure suddenly rises, or ischemic stroke from blood clots traveling from the heart to the brain.

According to doctor Trang, many long-term drug users show no obvious symptoms, but their heart muscle suffers silent damage. By the time symptoms appear, the disease is already in an advanced stage. The doctor recommends that individuals with a history of drug use, even if they have stopped, should undergo regular cardiovascular screening including electrocardiograms, echocardiograms, and cardiac enzyme tests.

Thanh Ba