| Cardiogenic shock induced by cocaine in swine with normal coronary arteries. | |
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MedLine Citation:
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PMID: 8111779 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The aim was to test the hypothesis that acute intravenous cocaine administration can cause coronary microvascular constriction culminating in myocardial ischaemia and cardiogenic shock. METHODS: Systemic haemodynamic variables and coronary blood flow were measured in 14 Yorkshire swine at baseline and following intravenous administration of 1, 3, and 10 mg.kg-1 of cocaine. Epicardial coronary artery diameter was measured from coronary arteriograms and coronary flow velocity was recorded with a Doppler flow wire. RESULTS: Cocaine produced a decrease in mean arterial pressure (65%), cardiac output (80%), and stroke volume (80%), and an increase in pulmonary artery diastolic pressure (60%). Although coronary blood flow decreased by 70%, epicardial coronary cross sectional area decreased by only 37-45%. Pretreatment with prazosin did not abolish the decrease in coronary blood flow. After administration of 10 mg.kg-1 of cocaine, five of 14 animals developed myocardial ischaemia and cardiogenic shock, culminating in ventricular fibrillation and death. CONCLUSIONS: In anaesthetised Yorkshire swine, cumulative intravenous doses of cocaine caused a significant reduction in coronary blood flow resulting in myocardial ischaemia, which cannot be attributed to epicardial vasoconstriction alone. This suggest that cocaine-induced coronary ischaemia may result from microvascular constriction, which is only partially prevented by alpha 1 blockade. In addition, direct toxic effects of cocaine on the myocardium may also contribute to the development of cardiogenic shock. |
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Authors:
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B D Núñez; L Miao; R E Kuntz; J N Ross; S Gladstone; D S Baim; P C Gordon; J P Morgan; J P Carrozza |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Cardiovascular research Volume: 28 ISSN: 0008-6363 ISO Abbreviation: Cardiovasc. Res. Publication Date: 1994 Jan |
Date Detail:
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Created Date: 1994-03-30 Completed Date: 1994-03-30 Revised Date: 2003-11-14 |
Medline Journal Info:
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Nlm Unique ID: 0077427 Medline TA: Cardiovasc Res Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 105-11 Citation Subset: IM |
Affiliation:
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Cardiovascular Division, Beth Israel Hospital, Boston, MA 02215. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Blood Pressure / drug effects Cardiac Output / drug effects Cocaine / toxicity* Coronary Circulation Coronary Vessels / anatomy & histology* Female Male Myocardial Ischemia / chemically induced Prazosin / pharmacology Regional Blood Flow / drug effects Shock, Cardiogenic / chemically induced* Stroke Volume / drug effects Swine |
| Chemical | |
Reg. No./Substance:
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19216-56-9/Prazosin; 50-36-2/Cocaine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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