title: Dexmedetomidine use in the setting of cocaine-induced hypertensive emergency and aortic dissection: a novel indication.
abstract: Aortic dissection is a potentially fatal but rare disease characterized by an aortic intimal tear with blood passing into the media creating a false lumen and with resultant high mortality depending on the location of dissection if not aggressively treated. Cocaine users are known to have a higher incidence of aortic dissection. We report here aortic dissection in a patient with cocaine abuse which did not respond to traditional medication regimes used currently in this setting. Worth mentioning is the use of an alpha-2 receptor selective agonist named Dexmedetomidine as a treatment modality to control hypertension in this patient, which is approved only for sedation of intubated and mechanically ventilated patients in the intensive care settings and for sedation during invasive procedures. This paper illustrates the practical beneficial role of Dexmedetomidine in controling blood pressure in the settings of cocaine-induced sympathetic surge when other treatment modalities fail.
authors.affiliation: Division of Cardiology, St. Luke's Roosevelt Hospital Center, University Hospital for College of Physicians and Surgeons of Columbia University, 1090 Amsterdam Avenue, New York, NY 10025, USA.
authors.forename: Fahad
authors.initials: F
authors.lastname: Javed
authors.forename: Alexandre Miguel
authors.initials: AM
authors.lastname: Benjo
authors.forename: Kiran
authors.initials: K
authors.lastname: Reddy
authors.forename: Muhammad
authors.initials: M
authors.lastname: Shoaib Akram
authors.forename: Shahzeb Afsar
authors.initials: SA
authors.lastname: Khan
authors.forename: Manpreet Singh
authors.initials: MS
authors.lastname: Sabharwal
authors.forename: Girish
authors.initials: G
authors.lastname: Nadkarni
authors.forename: Emad F
authors.initials: EF
authors.lastname: Aziz
authors.forename: Eyal
authors.initials: E
authors.lastname: Herzog