title: ST-segment elevation in patients with cocaine abuse and chest pain.
abstract: Use of cocaine may complicate the diagnosis of myocardial infarction (MI) and may influence treatment strategy. Patients with symptoms suggestive of acute coronary syndrome (ACS) should be questioned about the use of cocaine. Initial management of cocaine users presenting with chest pain and ST segment elevation should include administration of glyceryl trinitrate (GTN). Assessment for resolution of chest discomfort and ECG changes should be undertaken before fibrinolytic therapy or angiography is considered. We present a case of patient with chest pain (CP) and ST elevation after cocaine use, whose symptoms and ST changes promptly resolved after medical therapy. Our case highlights the importance of medical therapy in patient with CP and ST elevation after cocaine abuse, before activating cardiac catheterization laboratory for emergent angiography.
authors.affiliation: Section of Cardiology, University of Tennessee School of Medicine, Section of Cardiovascular Medicine Veterans Affairs Medical Center, 1030 Jefferson Avenue, Memphis TN, USA.
authors.forename: R
authors.initials: R
authors.lastname: Shah
authors.affiliation: Section of Cardiology, University of Tennessee School of Medicine, Memphis TN, USA.
authors.forename: S J
authors.initials: SJ
authors.lastname: Duncan
authors.affiliation: Section of Cardiology, University of Tennessee School of Medicine, Section of Cardiovascular Medicine Veterans Affairs Medical Center, 1030 Jefferson Avenue, Memphis TN, USA.
authors.forename: K B
authors.initials: KB
authors.lastname: Ramanathan
mesh_terms: D000368:Aged; D002637:Chest Pain / Q000188:drug therapy / Q000209:etiology*; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis; D005996:Nitroglycerin / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin