Brain cardiac events in Nigerian patients with cocaine abuse

Epidemiological evidences indicated that substance abuse disorders are increasingly prevalent among Nigerians. The psychosocial deleterious effects of these drugs appear well recognised, but their medical consequences are less often considered in the region. The potential for these drugs to precipitate life threatening cardiac and brain event needs to be reemphasised. We report the clinical and laboratory findings in 4 Nigerians in whom non-intravenous use (recreational and ritualistic) of cocaine was temporally related to acute myocardial ischaemia, cardiac dysarrhythmias, convulsion and cerebrovascular accident. These findings suggest that the observations--that underlying heart disorders were not sinequanon for the cardiotoxic effects of cocaine; the brain and cardiac consequences were not restricted to parenteral use of the drug; the development of seizures were not prerequisite for cerebrovascular accident and vice versa; and that massive doses of the drug needed not be ingested to produce toxic effects on the heart and brain--may also apply in these Nigerian patients. Perhaps with the increase in user population, it is timely to embark on public enlightenment on the medical dangers of cocaine abuse, as these are no less important than the psychosocial consequences.