title: Acute myocardial infarction temporally related to cocaine use. Clinical, angiographic, and pathophysiologic observations.
abstract: Ischemic chest pain syndromes and myocardial infarction occurred within minutes to hours of cocaine use in nine persons ages 23 to 39 years. Five developed symptoms after taking cocaine intranasally; three, after intravenous use; and one, after smoking cocaine. Four were habitual users and five were recreational users; eight also smoked cigarettes heavily. Ischemic syndromes recurred in five who continued to use cocaine. Coronary arteriography showed an abnormal infarct-related vessel (more than 50% stenosis, total occlusion, or intraluminal thrombus) in seven patients. The noninfarct-related vessels were normal in eight patients. The left anterior descending coronary artery and the anteroapical left-ventricular wall were involved in all patients. After three patients had successful thrombolysis of the obstructed infarct-related vessel, angiography showed a normal underlying vessel.
mesh_terms: D000328:Adult; D006328:Cardiac Catheterization; D003042:Cocaine / Q000009:adverse effects*; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D019966:Substance-Related Disorders / Q000150:complications*
chemical_list: D005343:Fibrinolytic Agents; D003042:Cocaine