Aortic dissection and cocaine use

Risk Factors for Thoracic Aortic Dissection

“…A previous IRAD report showed only 0.5% (5/921) patients with aortic dissection had a history of cocaine use in 2002 [ 207 ], while this proportion increased to 1.8% (63/3584) in 2014 [ 210 ]. Noting that IRAD study only recruited in-hospital patients while numbers of case report and autopsy study proved that a large number of cocaine users died of aortic dissection and rupture outside hospitals [ 204 , 213 , 214 , 215 , 216 ], leading to the concern about underestimated cocaine-use prevalence in both IRAD studies. However, the updated IRAD study found that cocaine-use patients had a higher risk of type B AAD (2.4%, 30/1252) than type A AAD (1.4%, 33/2332), which is consistent with a previous study [ 209 ].…”

Aortic dissection in cocaine abuse: A fatal case

“…remarkably their findings indicate that 37% treated for acute aortic dissection reported having used cocaine in the minutes or hours preceding their presentation [23][24][25][26]. Because of low incidence of aortic dissection in cocaine abusers (approximately 1% of patients), it has been suggested that the presence of pre-existent aortic disease allows a cocaine induced intimal injury to precipitate the aortic dissection process.…”

Double Suicide Due to the Ingestion of Levamisole-Adulterated Cocaine: Case Report and Review of the Literature

“…Cardiac arrhythmia and acute myocardial ischemia or infarction are the most common causes of cocaine-induced sudden cardiac death. In a few subjects, sudden hypertension develops, producing devastating results such as intracranial hemorrhage or thoracic aortic dissection/rupture (40). A variety of pulmonary complications have been described, mainly associated with nasal administration or inhalation: pulmonary barotrauma, bronchospasm, pneumonia.…”