Document Detail


Cardiogenic shock induced by cocaine in swine with normal coronary arteries.
MedLine Citation:
PMID:  8111779     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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    
Affiliation:
Cardiovascular Division, Beth Israel Hospital, Boston, MA 02215.
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MeSH Terms
Descriptor/Qualifier:
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:
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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