title: Transient cocaine-induced chest pain: a case series.
abstract: OBJECTIVE
  Acute chest pain and myocardial infarction are frequent complications of cocaine use. Indeed, these represent 40% of emergency department visits associated with cocaine use and 2% to 7% of all patients attending the emergency department for chest pain. Nevertheless, the prevalence of past cocaine-associated chest pain has never been evaluated in an outpatient facility for addiction. Our objective was to assess lifetime episodes of cocaine-associated chest pain in current cocaine users in an outpatient facility.
  
  
  METHODS
  Fifty consecutive, nonselected current cocaine users were retrospectively evaluated with a standardized interview and a medical assessment. The patients and the pain characteristics are described, and clinical and biological factors associated with experiencing cocaine-associated chest pain are studied with univariate and logistic regressions analyses.
  
  
  RESULTS
  Twenty-six subjects (52%) reported a history of chest pain associated with cocaine use. This pain was frequently described as oppressive (28%) and located in the retrosternal area (61.5%). The mean (±SD) time between cocaine use and the occurrence of the pain was 8 (±8) minutes and the mean duration was 22 (±236) minutes. Subjects who reported cocaine-associated chest pain reported an average of 12 (±7) distinct episodes. Patients describing chest pain could be predicted with one independent factor in our sample: age of onset of cocaine use (P = 0.042).
  
  
  CONCLUSIONS
  Transient cocaine-associated chest pains are frequent in current cocaine users attending specialized addiction facilities. Cardiological explorations and monitoring and risk-reduction interventions need to be provided to this specific population.
authors: From the Service de Psychiatrie (YD, MF, GD, VB, FB, JPL, FV), CSAPA Espace Murger, Hôpital Fernand Widal, AP-HP, Paris, France; Neuropsycopharmacologie des Addictions (MF, GD, VB, FB, JPL, FV), INSERM U705, CNRS UMR 8206, PRES Sorbonne Paris Cité, Paris, France; Pôle Addictologie Psychiatrie (YD, CO), CSAPA Monte-Cristo, AP-HP, HEGP, Paris, France; and Service de Cardiologie (EP), AP-HP, HEGP, Paris, France.
authors: Yavor
authors: Y
authors: Delchev
authors: Maeva
authors: M
authors: Fortias
authors: Gaël
authors: G
authors: Dupuy
authors: Cyrille
authors: C
authors: Orizet
authors: Vanessa
authors: V
authors: Bloch
authors: Etienne
authors: E
authors: Puymirat
authors: Frank
authors: F
authors: Bellivier
authors: Jean-Pierre
authors: JP
authors: Lépine
authors: Florence
authors: F
authors: Vorspan
mesh_terms: D000328:Adult; D015984:Causality; D002637:Chest Pain / Q000453:epidemiology*; D019970:Cocaine-Related Disorders / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004562:Electrocardiography / Q000379:methods; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010297:Paris / Q000453:epidemiology; D015995:Prevalence; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult