Document Detail


Cocaine-associated chest pain.
MedLine Citation:
PMID:  2039098     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVES: To describe the clinical and ECG features of cocaine abusers evaluated in the emergency department and admitted to the medical coronary care unit with chest pain consistent with myocardial ischemia. DESIGN: A four-month retrospective review of all cocaine abusers who presented to the ED with chest pain and a diagnosis of possible myocardial infarction. SETTING: Urban county hospital. TYPE OF PARTICIPANTS: Forty-eight adult cocaine abusers admitted with chest pain. MEASUREMENTS AND MAIN RESULTS: Patients included 34 men and 14 women with a mean age of 29 +/- 7.3 years. The average duration of cocaine abuse in 28 patients for whom it was reported was 5 +/- 4.8 years. Chest pain occurred within one hour of cocaine abuse in 13 admissions (27%), more than one hour after abuse in 13 admissions (27%), and it was not recorded in 23 admissions (47%). Initial ECGs were evaluated in all patients and revealed significant repolarization abnormalities consisting of abnormal ST segment elevations in 18 (37%) and T-wave inversions in 20 (41%) that often persisted on subsequent ECGs. Three patients sustained acute myocardial infarctions. CONCLUSIONS: Our findings confirm a small but significant incidence of myocardial infarction in cocaine abusers presenting to the ED with chest pain. The chronicity of cocaine abuse, the persistence of ECG abnormalities, and the variable temporal relationship of chest pain to cocaine abuse suggest possible chronic myocardial changes as etiologies of ischemia.
Authors:
J L Zimmerman; R P Dellinger; P A Majid
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  20     ISSN:  0196-0644     ISO Abbreviation:  Ann Emerg Med     Publication Date:  1991 Jun 
Date Detail:
Created Date:  1991-06-28     Completed Date:  1991-06-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  611-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Baylor College of Medicine, Houston, Texas.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Chest Pain / diagnosis,  epidemiology,  etiology*
Cocaine*
Coronary Care Units / statistics & numerical data
Diagnosis, Differential
Electrocardiography / standards*
Emergency Service, Hospital*
Female
Hospitals, County
Hospitals, Urban
Humans
Incidence
Male
Middle Aged
Myocardial Infarction / diagnosis,  epidemiology,  etiology*
Patient Admission / statistics & numerical data
Physical Examination
Recurrence
Retrospective Studies
Sensitivity and Specificity
Substance-Related Disorders / complications*,  urine
Time Factors
Chemical
Reg. No./Substance:
50-36-2/Cocaine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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