Asystole and ventricular fibrillation associated with cocaine intoxication

We discuss a patient with cocaine intoxication in whom the initial presentation was that of asystole and ventricular fibrillation. Cocaine has a direct toxic action on the heart and also sensitizes cardiac tissue to the action of catecholamines. Cocaine intoxication should be considered in any patient with unexplained cardiac arrest or ventricular arrhythmias.