Problems with cocaine use
Cocaine can cause multiple acute and chronic cardiac pathologies, including acute coronary syndromes, arrhythmias, accelerated hypertension, endocarditis, aortic dissection or rupture and cardiomyopathies. In this issue, Sultan et al. (see pages 142–4) present a case report of one of the rarer cardiovascular manifestations of cocaine use; that of coronary artery dissection.5
More commonly, cocaine has been reported to cause myocardial infarction (MI) due to acute thrombus formation or to severe coronary vasospasm, or accelerated atherosclerosis. In 2001, it was estimated that one of every four non-fatal MIs in per