Cocaine and the Heart

Abstract

The use of cocaine may be associated with either acute or chronic toxicity, and approximately 5% to 10% of emergency department visits in the United States are believed to be secondary to cocaine usage. Chest pain is the most common cocaine‐related medical problem, leading to the evaluation of approximately 64 000 patients annually for possible myocardial infarction, of which approximately 57% are admitted to the hospital, resulting in an annual cost greater than $83 million. There is a plethora of cocaine‐related cardiovascular complications, including acute myocardial ischemia and infarction, arrhythmias, sudden death, myocarditis, cardiomyopathy, hypertension, aortic ruptures, and endocarditis. There is no evidence to suggest that preexisting vascular disease is a prerequisite for the development of a cocaine‐related cardiovascular event, although it may be a potentiating factor, as may be nicotine and alcohol. Copyright © 2010 Wiley Periodicals, Inc.

Daño vascular asociado a uso de cocaína: Caso clínico

“…Desde el punto de vista clínico, los usuarios crónicos de cocaína exhiben un mayor riesgo de angina de pecho, infarto agudo del miocardio, muerte súbita de origen cardíaco y accidentes vasculares cerebrales 6,7 .…”

Chemical Cardiomyopathies: The Negative Effects of Medications and Nonprescribed Drugs on the Heart

“…Cocaine is associated with multiple cardiovascular complications including chest pain, myocardial ischemia/infarction, arrhythmias, aortic dissection, and stroke [20]. Felker et al, 7 reported cocaine use as a rare cause of cardiomyopathy, with 10 cases found among 1278 cases of dilated cardiomyopathy at Johns Hopkins Hospital [21].…”

“…Cocaine cardiomyopathy presents suddenly without a long prodrome. The electrocardiogram tends to show sinus tachycardia with frequent arrhythmias, including atrial fibrillation and ventricular tachycardia [20]. Echocardiogram demonstrates increased left ventricular mass and dysfunction.…”

Cellular and Immunological Regulation of Viral Myocarditis

“…Cocaine [ (Jentzen, 1989) reviewed in (Maraj et al, 2010)], virus induced, autoimmune (possibly due to resolved microbial infection), and even vaccine induced myocarditis (Cassimatis et al, 2004) have all been reported with a wide degree of occurrence. Though very rare, the vaccine induced aetiology is classified as idiopathic due to the poorly understood mechanism of inflammation.…”