Document Detail

Cardiogenic shock induced by cocaine in swine with normal coronary arteries.
MedLine Citation:
PMID:  8111779     Owner:  NLM     Status:  MEDLINE    
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 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 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.
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:
Type:  Journal Article    
Journal Detail:
Title:  Cardiovascular research     Volume:  28     ISSN:  0008-6363     ISO Abbreviation:  Cardiovasc. Res.     Publication Date:  1994 Jan 
Date Detail:
Created Date:  1994-03-30     Completed Date:  1994-03-30     Revised Date:  2003-11-14    
Medline Journal Info:
Nlm Unique ID:  0077427     Medline TA:  Cardiovasc Res     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  105-11     Citation Subset:  IM    
Cardiovascular Division, Beth Israel Hospital, Boston, MA 02215.
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MeSH Terms
Blood Pressure / drug effects
Cardiac Output / drug effects
Cocaine / toxicity*
Coronary Circulation
Coronary Vessels / anatomy & histology*
Myocardial Ischemia / chemically induced
Prazosin / pharmacology
Regional Blood Flow / drug effects
Shock, Cardiogenic / chemically induced*
Stroke Volume / drug effects
Reg. No./Substance:
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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