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Unrecognized left ventricular dysfunction in an apparently healthy cocaine abuse population
B D Bertolet1, G Freund, C A Martin
1Department of Medicine, University of Florida, Gainesville 32610.
Clinical Cardiology
|May 1, 1990
Summary
Cocaine abuse can lead to unrecognized left ventricular (LV) dysfunction in 7% of users, even when asymptomatic. This cardiac dysfunction, often subclinical, requires further long-term study to understand its full impact.
Area of Science:
- Cardiology
- Toxicology
- Public Health
Background:
- Cocaine use is associated with cardiovascular complications.
- Subclinical left ventricular (LV) dysfunction may occur in asymptomatic cocaine users.
- The prevalence and characteristics of unrecognized LV dysfunction in cocaine abusers are not well-defined.
Purpose of the Study:
- To determine the frequency and severity of clinically unrecognized left ventricular (LV) dysfunction in asymptomatic cocaine abusers.
- To assess cardiac function using non-invasive methods after a period of cocaine abstinence.
Main Methods:
- Eighty-four asymptomatic cocaine abusers were evaluated.
- Cardiac assessment included chest x-ray, electrocardiography (ECG), and radionuclide angiography.
- Abstinence from cocaine use for two weeks preceded cardiac evaluation.
Main Results:
- Left ventricular (LV) dysfunction was identified in 6 out of 84 subjects (7%).
- Regional wall motion abnormalities were found in 2 subjects, and reduced ejection fraction (<50%) in 4 subjects.
- Routine evaluations (chest x-ray, ECG) showed minimal abnormalities; dysfunction was clinically unrecognized.
Conclusions:
- A significant minority of asymptomatic cocaine abusers exhibit subclinical left ventricular (LV) dysfunction.
- Cocaine-induced cardiac dysfunction may be present without overt symptoms or abnormal routine cardiac tests.
- Long-term studies are needed to determine the clinical significance of subclinical LV dysfunction in this population.