Document Detail

Cocaine-associated myocardial infarction.
MedLine Citation:
PMID:  8795497     Owner:  NLM     Status:  MEDLINE    
Myocardial ischaemia and infarction has become a well-recognized sequelae of cocaine use. The possibility of recent cocaine use should be assessed in patients with potential myocardial ischaemia because the treatment of patients with myocardial ischaemia related to cocaine differs from that of patients with myocardial ischaemia unrelated to cocaine. Patients with cocaine-associated myocardial ischaemia should receive initial treatment with benzodiazepines to decrease central adrenergic stimulation. Aspirin should be used to reduce thrombus formation, and nitroglycerin to reverse coronary vasoconstriction. Patients with continued ischaemia can be treated with either low doses of phentolamine, or verapamil. If ischaemia continues after treatment with these agents mechanical reperfusion or thrombolytic therapy should be considered depending upon the clinical circumstances. Patients with myocardial ischaemia secondary to cocaine should not receive treatment with beta adrenergic antagonists as these agents enhance coronary vasoconstriction thereby worsening ischaemia.
J E Hollander
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Journal of the Royal Society of Medicine     Volume:  89     ISSN:  0141-0768     ISO Abbreviation:  J R Soc Med     Publication Date:  1996 Aug 
Date Detail:
Created Date:  1996-10-09     Completed Date:  1996-10-09     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7802879     Medline TA:  J R Soc Med     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  443-7     Citation Subset:  IM    
Department of Emergency Medicine, University Medical Center, Stony Brook, New York 11794-8350, USA.
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MeSH Terms
Aspirin / therapeutic use
Benzodiazepines / therapeutic use
Cocaine / adverse effects*
Middle Aged
Myocardial Infarction / chemically induced*,  drug therapy
Myocardial Ischemia / chemically induced
Nitroglycerin / therapeutic use
Platelet Aggregation Inhibitors / therapeutic use
Substance-Related Disorders*
Vasodilator Agents / therapeutic use
Reg. No./Substance:
0/Platelet Aggregation Inhibitors; 0/Vasodilator Agents; 12794-10-4/Benzodiazepines; 50-36-2/Cocaine; 50-78-2/Aspirin; 55-63-0/Nitroglycerin

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