Cocaine-induced myocardial infarction associated with severe reversible systolic dysfunction and pulmonary edema.
Myocardial infarction (MI) associated to cocaine use was originally reported in 1982 and cases are being encountered more frequently in our milieu. The literature regarding this diagnosis has included mostly cases of cocaine associated chest pain and MI without serious sequelae. A lesser number of reports however focus on the clinical presentation of severe myocardial dysfunction and severe pulmonary edema, with the mechanism for pulmonary edema still being debated. Although previously described individually, these manifestations are thought to be an uncommon complication of cocaine ingestion. In this article the subject is reviewed and we report our experience with two patients that presented to our care with severe pulmonary edema and concomitant severe left ventricular systolic dysfunction that resolved spontaneously with supportive therapy. It is felt that this clinical picture after cocaine use may be more common than expected. In this article we discuss the possible mechanisms associated to this presentation as well as review the literature regarding this subject.
Arzola-Castañer
Daniel
D
Department of Medicine, Cardiology Section, Medical Sciences Campus, University of Puerto Rico, San Juan, PR 00936-5067.
Johnson
Charles
C
D000328:Adult; D002316:Cardiotonic Agents / Q000627:therapeutic use; D003042:Cocaine / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000150:complications*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D011654:Pulmonary Edema / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy; D011859:Radiography; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000009:adverse effects*; D018754:Ventricular Dysfunction / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy
D002316:Cardiotonic Agents; D014662:Vasoconstrictor Agents; D003042:Cocaine