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Cocaine-associated chest pain

Joel T Levis1, Gus M Garmel

  • 1Kaiser Santa Clara Medical Center, Department of Emergency Medicine, CA 95051, USA. joel.levis@kp.org

Emergency Medicine Clinics of North America
|October 4, 2005
PubMed

Insights

Cocaine use frequently causes chest pain in emergency department patients. Understanding cocaine

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Pharmacology

Background:

  • Over 30 million individuals in the United States use cocaine.
  • Cardiovascular complaints, particularly chest pain, are common among patients presenting to emergency departments (EDs) after cocaine use.
  • While myocardial ischemia and infarction are less frequent causes, they represent serious complications of cocaine-associated chest pain.

Purpose of the Study:

  • To review the pharmacology of cocaine.
  • To elucidate cocaine's role in the pathogenesis of chest pain, focusing on myocardial ischemia and infarction.
  • To outline current diagnostic and management strategies for cocaine-associated chest pain in the ED.

Main Methods:

  • Literature review of cocaine pharmacology.
  • Analysis of studies on cocaine-associated cardiovascular events.
  • Synthesis of current clinical guidelines for diagnosis and management.

Main Results:

  • Cocaine's stimulant properties can lead to coronary artery vasospasm and myocardial ischemia.
  • Chest pain is a primary presentation, necessitating differentiation from other cardiac causes.
  • Appropriate diagnostic workup and timely management are crucial for patient outcomes.

Conclusions:

  • Physicians must be aware of cocaine's cardiovascular effects.
  • Prompt recognition and management of cocaine-associated chest pain can mitigate adverse events.
  • Further research into specific treatment protocols may be warranted.

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