Cardiac magnetic resonance in cocaine-induced myocardial damage: cocaine, heart, and magnetic resonance

D’Ugo, Emilia; Barison, Andrea; Todiere, Giancarlo; Grigoratos, Chrysanthos; Aquaro, Giovanni Donato

doi:10.1007/s10741-020-09983-3

Cited by 13 publications

(12 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Many studies have provided significant evidence explaining the relationship between cocaine use and the onset of cocaine-induced morbidity (including cardiovascular, neurovascular, psychiatric, and infectious illnesses) and mortality over time. [2,3,4,6,7] Cocaine intoxication disrupts the homeostasis in nearly all organ systems throughout the human body; however, the cardiovascular system is responsible for most adverse effects. [8] The major cardiovascular complications associated with patients that use cocaine include myocardial infarction (MI), aortic dissection (AD), heart failure and cardiomyopathies, stroke, excessive hypertension, chest pain, and arrhythmia [9].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Symptoms and chronicity of this condition severely affect the quality of life. According to the Framingham heart study, the heart failure mortality rate is approximately 10% at 30 days after diagnosis, 20-30% at one year and 45-60% at 5 years [3,[4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cocaine induced heart failure: report and literature review

Elkattawy

Alyacoub

Al-Nassarei

et al. 2021

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

Heart failure is a complex clinical syndrome associated with high mortality and morbidity, creating a major public healthcare problem. It has a variety of etiologies, including substance abuse. Cocaine-induced cardiotoxicity is caused by direct effects of inhibition of sodium channels and indirect effects by inhibiting catecholamine uptake leading to increased sympathetic activity. Management is through the cessation of cocaine use and implantation of guideline-directed medical therapy for heart failure with the exception of beta-blockers as their safe usage is still controversial due to the risk of the unopposed alpha-adrenergic activity. Dexmedetomidine (Precedex) and Benzodiazepines (i.e., midazolam) are options for patients that demonstrate signs and symptoms of acute cocaine intoxication. If the actions of benzodiazepines fail to achieve hemodynamic stability, nitroglycerin may be used (especially in patients with cocaine-associated chest pain and hypertension). Cardiac transplantation is recommended for those who have demonstrated severe cardiovascular disease from cocaine. We present a 43-year-old male with a long-standing history of cocaine use who developed cardiomyopathy and severe acute decompensated heart failure found to have an ejection fraction of <20% admitted to the intensive care unit. He required inotropic support with milrinone and mechanical ventilation. He was later extubated and then discharged with an outpatient evaluation for a cardiac transplant.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Cocaine induced heart failure: report and literature review

Elkattawy

Alyacoub

Al-Nassarei

et al. 2021

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

show abstract

“…While the parent drug, cocaine, is associated with an elevated risk for cardiovascular disease, myocardial infarction, and arrhythmias [ 44 , 45 ], most risk assessment metrics for heart disease do not ask about cocaine use. In fact, except for the use of alcohol and tobacco, some potentially relevant substances are not mentioned in cardiovascular screening [ 46 ].…”

Section: Reviewmentioning

confidence: 99%

Cocaethylene: When Cocaine and Alcohol Are Taken Together

Pergolizzi¹,

Breve²,

Magnusson³

et al. 2022

Cureus

View full text Add to dashboard Cite

Cocaine is taken frequently together with ethanol and this combination produces a psychoactive metabolite called cocaethylene which has similar properties to the parent drug and may be more cardiotoxic. Cocaethylene has a longer half-life than cocaine, so that people who combine cocaine and ethanol may experience a longer-lasting, as well as more intense, psychoactive effect. Cocaethylene is the only known instance where a new psychoactive substance is formed entirely within the body. Although known to science for decades, cocaethylene has not been extensively studied and even its metabolic pathways are not entirely elucidated. Like its parent drug, cocaethylene blocks the reuptake of dopamine and increases post-synaptic neuronal activity; the parent drug may also block reuptake of serotonin as well. Cocaethylene has been studied in animal models in terms of its pharmacology and its potential neurological effects. Since the combination of cocaine and alcohol is commonly used, it is important for clinicians to be aware of cocaethylene, its role in prolonging or intensifying cocaine intoxication, and how it may exacerbate cocaineinduced cardiovascular disorders. Most cardiac-related risk assessment tools do not ask about cocaine use, which can prevent clinicians from making optimal therapeutic choices. Greater awareness of cocaethylene is needed for clinicians, and those who use cocaine should also be aware of the potential for polysubstance use of cocaine and ethanol to produce a potentially potent and long-lasting psychoactive metabolite.

show abstract

“…Source: References [1,2,4,6,12,14,19,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36] .…”

Section: Arrhythmiasmentioning

confidence: 99%

Cocaine and Cardiotoxicity: A Literature Review

Pergolizzi¹,

Magnusson²,

LeQuang³

et al. 2021

Cureus

View full text Add to dashboard Cite

Long-term cocaine use, as well as acute cocaine use, is associated with adverse cardiovascular consequences, including arrhythmias, angina, myocardial infarction, heart failure, and other conditions. Over the long term, cocaine can result in structural changes to the heart such as increased left-ventricular mass and decreased left-ventricular end-diastolic volume. Patients arriving with cocaine-associated cardiovascular complaints may not be forthcoming about their cocaine or polysubstance abuse or may be unresponsive. The role of beta-blockers, a first-line treatment for many forms of heart disease, is controversial in this population. Cocaine is a powerful sympathomimetic agent, and it was thought that beta-blockade would result in unopposed alpha-adrenergic stimulation and adverse consequences. A number of small, singlecenter, retrospective and observational studies suggest that beta-blockers may be safe, effective, and beneficial in this population. Further study is needed to clarify the role of beta-blockers in this population.

show abstract

Cardiac magnetic resonance in cocaine-induced myocardial damage: cocaine, heart, and magnetic resonance

Cited by 13 publications

References 37 publications

Cocaine induced heart failure: report and literature review

Cocaine induced heart failure: report and literature review

Cocaethylene: When Cocaine and Alcohol Are Taken Together

Cocaine and Cardiotoxicity: A Literature Review

Contact Info

Product

Resources

About