Cocaine and the heart

Abstract

Cocaine is the second commonest illicit drug used and the most frequent cause of drug related deaths. Its use is associated with both acute and chronic complications that may involve any system, the most common being the cardiovascular system. Cocaine misuse has a major effect in young adult drug users with resulting loss of productivity and undue morbidity with cocaine related cardiac and cerebrovascular effects. Many cocaine users have little or no idea of the risks associated with its use. Patients, health care professionals, and the public should be educated about the dangers and the considerable risks of cocaine use. This review concentrates on the cardiovascular effects of cocaine and their management.

Cocaine-related acute aortic dissection: Patient demographics and clinical outcomes

“…The association of cocaine use with acute aortic dissection and the causal relationship of cocaine use with acute aortic dissection are not well defined (4,10,14). Several case reports of aortic dissection have been reported (15)(16)(17)(18)(19), but the article by Hsue et al (20) was the only study that clearly linked cocaine use and aortic dissection (20).…”

“…Cocaine acts as a powerful sympathomimetic agent (14). It blocks the presynaptic reuptake of noradrenaline and dopamine, producing high levels of these neurotransmitters at the postsynaptic receptors (4).…”

“…Cocaine (benzoylmethylecgonine, C 17 H 21 NO 4 ) is an alkaloid extract from the leaf of the Erythroxylon coca plant, which is usually grown in South America (14). It is available in hydrochloride salt and freebase ('crack' cocaine) forms.…”

Cocaine cardiomyopathy: A case report

“…In 2005, 2.4 million persons were actively using cocaine. The younger age groups of 18-25 are the most common users and it is estimated that 11% of the population has used it at some point (2). The 2008 National Survey on Drug Use and Health reported that approximately 36.8 million Americans aged 12 years and older (14.7% of Americans in that age group) had tried cocaine at least once (3).…”

Exercise Stress Testing in Recently Abstinent Chronic Cocaine Abusers

“…The acute cardiovascular effects of cocaine, such as dose-dependent increases in heart rate, blood pressure, and vascular resistance, and decreased blood flow in several vascular beds, have been demonstrated in human laboratory studies (5)(6)(7). Less well studied are the cardiovascular sequelae of chronic cocaine use outside the context of immediate cocaine use.…”