Tag Archives: cocaine

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

Case history A 24-year-old male security guard presented to the emergency department with residual central chest ache. The patient developed central, intense chest tightness radiating to the left shoulder four hours after taking 1 g of cocaine, and presented to our emergency room 12 hours later. He had no risk factors for atherosclerosis nor any prior collagen vascular disorders or autoimmune vasculitis. His electrocardiogram (ECG) revealed antero-lateral ST-elevation myocardial infarction (STEMI). He was haemodynamically stable with no evidence of left ventricular failure. Troponin-I was >50 IU (normal <0.03), with a normal baseline li