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Cocaine-induced intramural hematoma of the ascending aorta

E Neri1, T Toscano, M Massetti

  • 1Thoracic and Cardiovascular Department, University Hospital, Siena, Italy.

Insights

A 35-year-old man developed intramural aortic hematoma after cocaine and crack cocaine use. This rare case highlights potential cardiovascular complications associated with stimulant drug use.

Area of Science:

  • Cardiology
  • Toxicology
  • Vascular Medicine

Background:

  • Cocaine and crack cocaine are potent stimulants with known cardiovascular risks.
  • Aortic emergencies, such as dissection and intramural hematoma, are serious potential complications.

Observation:

  • A 35-year-old male patient presented with symptoms suggestive of an acute aortic event.
  • The patient had recently used cocaine and smoked crack cocaine prior to symptom onset.

Findings:

  • The patient was diagnosed with an intramural aortic hematoma.
  • This is the first reported case of intramural aortic hematoma associated with cocaine and crack cocaine use in the English medical literature.

Implications:

  • This case underscores the critical need to consider stimulant drug use in the differential diagnosis of acute aortic syndromes.
  • Further research is warranted to elucidate the mechanisms linking stimulant use to aortic intramural hematoma and dissection.

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