Cardiac and Hemodynamic Assessment of Patients with Cocaine-Associated Chest Pain Syndromes

Bm, Baumann; Perrone, Jeanmarie; Se, Hornig; Shofer, FS; Je, Hollander

doi:10.1081/clt-100100933

Cited by 17 publications

(3 citation statements)

References 21 publications

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“…Alphablockers, such as phentolamine to block the vasomotor effect of norepinephrine, may be used. In general, betablockers should be avoided in the setting of cocaine toxicity (24). Beta-blockers have been reported to increase blood pressure, reduce cardiac output and tissue perfusion, and possibly increase mortality (8).…”

Section: Management Of Cocaine-induced Renal Failurementioning

confidence: 99%

An overview of non-cardiac cocaine toxicity

Glauser¹,

Queen²

2007

The Journal of Emergency Medicine

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Section: Management Of Cocaine-induced Renal Failurementioning

confidence: 99%

An overview of non-cardiac cocaine toxicity

Glauser¹,

Queen²

2007

The Journal of Emergency Medicine

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“…As in other studies, the great majority of our cocaine-consuming patients with chest pain were young people, in their third decade of life, and in general presumably at low risk of adverse cardiovascular events [ 10 , 12 , 13 ]. Thus none of them required admission to hospital.…”

Section: Discussionmentioning

confidence: 52%

Undisclosed cocaine use and chest pain in emergency departments of Spain

Burillo-Putze

López

Borreguero-León

et al. 2009

Scand J Trauma Resusc Emerg Med

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Aims: Illicit cocaine consumption in Spain is one of the highest in Europe. Our objective was to study the incidence of undisclosed cocaine consumption in patients attending in two Spanish Emergency Departments for chest pain. Methods:We analysed urine samples from consenting consecutive patients attending ED for chest pain to determine the presence of cocaine, and other drugs, by semiquantative tests with fluorescence polarization immunoassay (FPIA).Results: Of 140 cases, 15.7 presented positive test for drugs, and cocaine was present in 6.4%. All cocaine-positive patients were younger (p < 0.001); none was admitted to Hospital (p = 0.08). No significant differences in ED stay or need for hospitalization were found between cocaine-positive and negative patients. Conclusion:This finding in chest pain patients who consented to urine analysis suggests that the true incidence of cocaine use leading to such ED visits may be higher.

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“…Both cocaine-and psychostimulant-related ED visits were associated with cardiopulmonary concerns, even after adjusting for cardiovascular risk factors. Both cocaine and psychostimulants are known cardiotoxins, and both acute and chronic use can lead to adverse events such as myocardial ischemia, stroke, and heart failure [17,46,47]. Simultaneous cocaine and alcohol use is also common and contributes to worse cardiovascular outcomes [48,49].…”

Section: Weighted % (95% Ci)mentioning

confidence: 99%

Emergency department visits and trends related to cocaine, psychostimulants, and opioids in the United States, 2008–2018

et al. 2022

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Background Drug-related emergency department (ED) visits are escalating, especially for stimulant use (i.e., cocaine and psychostimulants such as methamphetamine). We sought to characterize rates, presentation, and management of ED visits related to cocaine and psychostimulant use, compared to opioid use, in the United States (US). Methods We used 2008–2018 National Hospital Ambulatory Medical Care Survey data to identify a nationally representative sample of ED visits related to cocaine and psychostimulant use, with opioids as the comparator. To make visits mutually exclusive for analysis, we excluded visits related to 2 or more of the three possible drug categories. We estimated annual rate trends using unadjusted Poisson regression; described demographics, presenting concerns, and management; and determined associations between drug-type and presenting concerns (categorized as psychiatric, neurologic, cardiopulmonary, and drug toxicity/withdrawal) using logistic regression, adjusting for age, sex, race/ethnicity, and homelessness. Results Cocaine-related ED visits did not significantly increase, while psychostimulant-related ED visits increased from 2008 to 2018 (2.2 visits per 10,000 population to 12.9 visits per 10,000 population; p < 0.001). Cocaine-related ED visits had higher usage of cardiac testing, while psychostimulant-related ED visits had higher usage of chemical restraints than opioid-related ED visits. Cocaine- and psychostimulant-related ED visits had greater odds of presenting with cardiopulmonary concerns (cocaine adjusted odds ratio [aOR] 2.95, 95% CI 1.70–5.13; psychostimulant aOR 2.46, 95% CI 1.42–4.26), while psychostimulant-related visits had greater odds of presenting with psychiatric concerns (aOR 2.69, 95% CI 1.83–3.95) and lower odds of presenting with drug toxicity/withdrawal concerns (aOR 0.47, 95%CI 0.30–0.73) compared to opioid-related ED visits. Conclusion Presentations for stimulant-related ED visits differ from opioid-related ED visits: compared to opioids, ED presentations related to cocaine and psychostimulants are less often identified as related to drug toxicity/withdrawal and more often require interventions to address acute cardiopulmonary and psychiatric complications.

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Cardiac and Hemodynamic Assessment of Patients with Cocaine-Associated Chest Pain Syndromes

Cited by 17 publications

References 21 publications

An overview of non-cardiac cocaine toxicity

An overview of non-cardiac cocaine toxicity

Undisclosed cocaine use and chest pain in emergency departments of Spain

Emergency department visits and trends related to cocaine, psychostimulants, and opioids in the United States, 2008–2018

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