Cocaine and the heart.
The use of cocaine may be associated with either acute or chronic toxicity, and approximately 5% to 10% of emergency department visits in the United States are believed to be secondary to cocaine usage. Chest pain is the most common cocaine-related medical problem, leading to the evaluation of approximately 64,000 patients annually for possible myocardial infarction, of which approximately 57% are admitted to the hospital, resulting in an annual cost greater than $83 million. There is a plethora of cocaine-related cardiovascular complications, including acute myocardial ischemia and infarction, arrhythmias, sudden death, myocarditis, cardiomyopathy, hypertension, aortic ruptures, and endocarditis. There is no evidence to suggest that preexisting vascular disease is a prerequisite for the development of a cocaine-related cardiovascular event, although it may be a potentiating factor, as may be nicotine and alcohol.
Albert Einstein Medical Center, Department of Cardiovascular Diseases, Philadelphia, Pennsylvania, USA. marajs@einstein.edu
Suraj
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Maraj
Vincent M
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Figueredo
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Lynn Morris
D000787:Angina Pectoris / Q000139:chemically induced / Q000191:economics; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000191:economics / Q000503:physiopathology / Q000628:therapy; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D003042:Cocaine / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000191:economics / Q000503:physiopathology; D004636:Emergency Service, Hospital / Q000191:economics; D017048:Health Care Costs; D006321:Heart / Q000187:drug effects*; D006801:Humans; D012307:Risk Factors; D014481:United States
D000697:Central Nervous System Stimulants; D003042:Cocaine