Prevalence of Heart Disease in Asymptomatic Chronic Cocaine Users

Abstract

To determine the prevalence of heart disease in outpatient young asymptomatic chronic cocaine users, 35 cocaine users and 32 age-matched controls underwent resting and exercise electrocardiography (ECG) and Doppler echocardiography. Findings consistent with coronary artery disease were detected in 12 (34%) patients and 3 (9%) controls (p = 0.01). Decreased left ventricular systolic function was demonstrated in 5 (14%) patients, but in none of the controls (p = 0.055). Finally, resting and peak exercise abnormal left ventricular filling was detected in 38 and 35% of patients as compared to 19 and 9% of controls, respectively (p = 0.11 and 0.02, respectively). We conclude that coronary artery or myocardial disease is common (38%) in young asymptomatic chronic cocaine users. Therefore, screening ECG and echocardiography may be warranted in these patients.

Long term effects of cocaine on the heart assessed by cardiovascular magnetic resonance at 3T

“…We also observed global LV systolic dysfunction in 34% of our series. This prevalence was higher than in previous echocardiographic reports on asymptomatic patients, in which it ranged from 0% to 14% [7,13,32,36]. Still, we only found mild systolic dysfunction, with the lowest LVEF being 48%, probably because we assessed the chronic effect of cocaine and not the acute phase effect, and also because our cocaine abusers were asymptomatic and likely to have less severe cardiac involvement.…”

“…Overall, some degree of cardiac involvement was shown in 71% of CA, and LV dysfunction was related to number of years of regular cocaine use, which may have practical importance in these patients’ medical care. It has been previously shown that cocaine is cardiotoxic in both symptomatic [32] and asymptomatic [13,33] CA, but, as far as we are aware, this is the first comprehensive study to assess with CMR cocaine cardiac and vascular toxicity in a reasonably large cohort of consecutive, non-selected, asymptomatic CA, comparing LV and RV results to healthy age and gender matched controls.…”

Multi-Organ Iron Overload in an African-American Man with <i>ALAS2</i> R452S and <i>SLC40A1</i> R561G

“…Cardiomyopathy due to myocardial siderosis has been reported in other patients with iron overload due to sideroblastic anemia [23]. Cocaine use, reported by the present patient, increases the risk of left ventricular dysfunction, myocardial infarction and other manifestations of heart disease [24, 25]. This accounts for his myocardial infarction at presentation, and may have exacerbated his cardiomyopathy.…”

Acute hypopituitarism in a pregnant patient after cardiac gunshot injury

“…Myocardial dysfunction is common in young asymptomatic chronic cocaine users. In one study, 14% of young chronic cocaine users had decreased LV systolic function by echocardiography and more than a third had abnormal LV filling during exercise testing [17]. It is also interesting to speculate whether cocaine abuse contributed to the development of hypopituitarism.…”