title: Valsalva manoeuvre effect on distribution of lung damage in heroin inhalation.
abstract: This article reports the case of a patient demonstrating acute bilateral pneumonitis almost completely confined to the upper lobes as a result of inhaling heroin. We attribute this distribution to the patient performing the Valsalva manoeuvre immediately after inhaling heroin. This pattern has not been reported before and we believe it may be seen more frequently owing to a switch amongst drug users from intravenous to inhaled heroin.
authors.affiliation: Department of Radiology, Royal Liverpool Hospital, Liverpool, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Prowse
authors.forename: T
authors.initials: T
authors.lastname: Lima
authors.forename: K L
authors.initials: KL
authors.lastname: Irion
authors.forename: H
authors.initials: H
authors.lastname: Burhan
authors.forename: B
authors.initials: B
authors.lastname: Hochhegger
authors.forename: E
authors.initials: E
authors.lastname: Marchiori
mesh_terms: D000208:Acute Disease; D055371:Acute Lung Injury / Q000139:chemically induced / Q000000981:diagnostic imaging* / Q000503:physiopathology; D000280:Administration, Inhalation; D001784:Blood Gas Analysis; D005260:Female; D003932:Heroin / Q000009:adverse effects* / Q000493:pharmacokinetics; D006556:Heroin Dependence / Q000150:complications*; D006801:Humans; D008875:Middle Aged; D011014:Pneumonia / Q000139:chemically induced / Q000000981:diagnostic imaging* / Q000503:physiopathology; D013902:Radiography, Thoracic; D014636:Valsalva Maneuver
chemical_list: D003932:Heroin