title: Cocaine use and acute myocardial infarction.
abstract: Cocaine use in the United States is widespread, affecting more than 30 million Americans. Although many of these persons do not seek healthcare, the overriding cause for hospitalization is cocaine-associated chest pain. Because only a minority of these patients suffer myocardial injury, it is important to exclude even rarer life-threatening causes for chest pain, such as aortic dissection or pneumothorax. Following that, a thorough knowledge of the pathophysiology and existing literature helps to provide cost-effective care, which focuses resources on those patients most likely to suffer complications. Regardless of the severity of complications, referral to cocaine detoxification programs, counseling, social support, and outpatient follow-up care for modification of cardiac risk factors is a fundamental component of long-term patient care.
authors.affiliation: Department of Health, New York City Poison Control Center, New York, New York, USA. hahn66@pol.net
authors.forename: I H
authors.initials: IH
authors.lastname: Hahn
authors.forename: R S
authors.initials: RS
authors.lastname: Hoffman
mesh_terms: D001145:Arrhythmias, Cardiac / Q000209:etiology / Q000628:therapy; D002637:Chest Pain / Q000209:etiology; D003042:Cocaine / Q000009:adverse effects* / Q000494:pharmacology; D003937:Diagnosis, Differential; D018765:Dopamine Uptake Inhibitors / Q000009:adverse effects* / Q000494:pharmacology; D004636:Emergency Service, Hospital; D006801:Humans; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000473:pathology; D017202:Myocardial Ischemia / Q000139:chemically induced*
chemical_list: D018765:Dopamine Uptake Inhibitors; D003042:Cocaine