| Cardiac complications of cocaine abuse. | |
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MedLine Citation:
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PMID: 7720292 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cardiac complications of cocaine abuse and a rational approach to evaluating and managing them are described. Cardiac abnormalities reported among asymptomatic cocaine abusers include echocardiographic left ventricular hypertrophy and segmental wall motion abnormalities. Electrocardiogram may reveal increased QRS voltage, ST-T changes, and pathologic Q waves. Episodes of ST elevation may be seen during Holter monitoring. The management of cocaine-abusing patients who present to an emergency room with acute chest pain is controversial because the two reported studies yielded conflicting results regarding the incidence of myocardial infarction (MI). Even in the absence of infarction, electrocardiographic abnormalities are common among these patients, which complicates the decision-making regarding hospitalization. Pathophysiology of cocaine-related MI is discussed. Distinct clinical features of cocaine-related MI make it clear that the association between the two is not just temporal. However, considering the number of persons abusing cocaine, it is a rarity. Beta-adrenergic blockers should be avoided in the treatment of cocaine-induced myocardial ischemia which is best treated with nitrates and calcium-channel blockers. Reports of cocaine-induced myocarditis and cardiomyopathy are reviewed. Experimental studies and clinical case reports suggest that cocaine may cause lethal arrhythmias. Cocaine prolongs repolarization by a depressant effect on potassium current and may generate early afterdepolarizations. It is possible that cocaine-associated arrhythmias are secondary to vasospasm-related ischemia and reperfusion as well. |
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Authors:
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S Chakko; R J Myerburg |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Clinical cardiology Volume: 18 ISSN: 0160-9289 ISO Abbreviation: Clin Cardiol Publication Date: 1995 Feb |
Date Detail:
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Created Date: 1995-05-23 Completed Date: 1995-05-23 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7903272 Medline TA: Clin Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 67-72 Citation Subset: IM |
Affiliation:
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University of Miami School of Medicine, Florida, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angina Pectoris
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etiology Arrhythmias, Cardiac / etiology Cocaine* Echocardiography Electrocardiography Heart Diseases / diagnosis, etiology* Humans Myocardial Infarction / etiology Substance-Related Disorders / complications* |
| Chemical | |
Reg. No./Substance:
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50-36-2/Cocaine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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