Aorto-pericardial fistula in an intravenous drug addict with infective endocarditis of the aortic valve

This paper presents a fatal case of a 31-year-old female intravenous amphetamine user in the late stage of pregnancy who suffered a sudden collapse at home. The autopsy revealed hemopericardium resulting from an aorto-pericardial fistula. Histological examination of the aortic valve revealed multiple abscesses. Moreover, the histological examination also proved the presence of foreign bodies in the fistula and a granulomatous reaction with numerous multinucleated giant cells surrounding the bodies in the wall of the aorto-pericardial fistula necrosis as well as purulent phlegmonous inflammation. The foreign bodies were positive for amphetamine and methamphetamine. These findings suggest that the aorto-pericardial fistula developed due to intravenous drug abuse.