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Tachycardia-Induced Cardiomyopathy As a Chronic Heart Failure Model in Swine
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Cocaine induced heart failure: report and literature review

Sherif Elkattawy1, Ramez Alyacoub1, Abraham Al-Nassarei2

  • 1Department of Internal Medicine, Rutgers New Jersey Medical School/Trinitas Regional Medical Center Program, Elizabeth, NJ, USA.

Journal of Community Hospital Internal Medicine Perspectives
|July 2, 2021
PubMed

Insights

Cocaine use can cause severe heart failure, requiring intensive care and potential cardiac transplant evaluation. Management focuses on stopping cocaine and specific heart failure treatments, avoiding beta-blockers due to risks.

Area of Science:

  • Cardiology
  • Toxicology
  • Internal Medicine

Background:

  • Heart failure is a significant public health issue with diverse causes, including substance abuse.
  • Cocaine-induced cardiotoxicity results from direct and indirect effects on cardiac function.
  • Management of cocaine-induced heart failure is complex, with specific considerations for beta-blocker use.

Purpose of the Study:

  • To review the pathophysiology and management of cocaine-induced cardiotoxicity.
  • To present a case study of severe acute decompensated heart failure secondary to chronic cocaine use.
  • To highlight the role of advanced therapies, including mechanical ventilation and potential cardiac transplantation.

Main Methods:

  • Literature review on cocaine cardiotoxicity and heart failure management.
  • Case report of a 43-year-old male with chronic cocaine use presenting with severe heart failure.
  • Analysis of treatment strategies including inotropic support, mechanical ventilation, and transplant evaluation.

Main Results:

  • The patient presented with cardiomyopathy and severe acute decompensated heart failure (ejection fraction <20%).
  • He required intensive care unit admission, inotropic support (milrinone), and mechanical ventilation.
  • The case underscores the severity of cocaine-induced heart failure and the need for specialized management.

Conclusions:

  • Cocaine-induced cardiotoxicity can lead to severe, life-threatening heart failure.
  • Treatment involves cessation of cocaine, guideline-directed medical therapy (with caution regarding beta-blockers), and supportive care.
  • Cardiac transplantation may be necessary for advanced cases of cocaine-related cardiovascular disease.

Keywords:
Heart failurecardiomyopathycocaine

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