Recreational myocardial infarction legacy of the 1990s

Cocaine is a common drug of abuse with a potential lethal cardiac toxicity. Although cocaine abuse has reached epidemic proportions, the number of cardiovascular complications observed clinically remains low. Over 30% of men and 20% of women between the ages of 26 and 34 have used cocaine at least once. Moreover, more than 30 million Americans have used cocaine at some time, and more than five million are regular abusers. Chest pain is one of the most common reasons for cocaine users to seek medical attention. Over 64,000 patients are evaluated annually for cocaine-related chest pain, of whom more than 57% are admitted to hospital for possible myocardial ischaemia, at an annual cost of more than $83 million.