The pathology and etiology of cocaine-induced heart disease

During the last two years, reports have appeared linking cocaine use to virtually every type of heart disease. Ischemic events have been reported regularly, and there appears to be a strong relationship between cocaine use, contraction bands, and sudden arrhythmic death. The evidence concerning cocaine-induced myocarditis, cardiomyopathy, and valvular heart disease is less clear. In this article, we review the currently known morphological changes induced by cocaine and discuss the possible mechanisms of action leading to these changes.