Concurrent myocardial and cerebral infarctions after intranasal cocaine use.
OBJECTIVE
Cardiac and cerebrovascular complications associated with cocaine abuse have increasingly been reported, but concurrent development of cocaine-induced cardiac disease and stroke has rarely been reported.


METHODS
A 37-year-old man with a remote history of intravenous heroin and amphetamine use, cardiomyopathy, and recent cocaine use developed chest pain and ventricular tachycardia 30 minutes after intranasal cocaine hydrochloride use and jogging on a cold winter morning. Ventricular tachycardia was converted to atrial fibrillation. He was proven to have a small myocardial infarction. Within 6 hours of cocaine use he suffered a left hemisphere stroke. Cardiac electrophysiologic evaluation revealed inducible ventricular tachycardia.


CONCLUSIONS
To our knowledge, this is the first report of concurrent myocardial infarction, life-threatening ventricular arrhythmias, and cerebral infarction temporally related to cocaine use. It is probable that one mechanism by which cocaine use causes stroke is to trigger expression of a known cardiac source of embolism.
Sloan
M A
MA
Department of Neurology, University of Maryland School of Medicine, Baltimore.
Mattioni
T A
TA
D000281:Administration, Intranasal; D000328:Adult; D002544:Cerebral Infarction / Q000139:chemically induced* / Q000150:complications; D003042:Cocaine / Q000009:adverse effects*; D003080:Cold Temperature; D006801:Humans; D007590:Jogging; D008297:Male; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000150:complications
D003042:Cocaine