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[Thoracic pain]

W Gmür1, G Hold, P Greminger

  • 1Departement für Innere Medizin, Universitätsspital Zürich und Medizinische Klinik, Stadtspital Triemli, Zürich.

Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|June 15, 1993
PubMed

Insights

Cocaine use can cause severe chest pain, myocardial infarction, and rhabdomyolysis. Coronary vasospasm due to cocaine was the likely cause in a patient with no significant coronary stenoses.

Area of Science:

  • Cardiology
  • Toxicology

Background:

  • Cocaine is a potent stimulant with known cardiovascular risks.
  • Myocardial infarction and rhabdomyolysis are serious potential consequences of cocaine use.

Observation:

  • A 28-year-old male presented with severe chest pain, diagnosed with anterior myocardial infarction and rhabdomyolysis.
  • Initial investigations included electrocardiogram (ECG) and laboratory tests.
  • Coronary arteriography revealed no significant coronary artery stenoses.

Findings:

  • The patient's presentation was strongly linked to recent cocaine consumption.
  • Coronary vasospasm secondary to cocaine use was postulated as the cause of myocardial infarction.
  • The absence of obstructive coronary artery disease supports the vasospasm hypothesis.

Implications:

  • This case highlights the critical importance of considering cocaine-induced coronary vasospasm in patients presenting with acute coronary syndromes.
  • Early recognition and management of cocaine-related cardiovascular events are crucial.
  • Understanding the mechanisms of cocaine's cardiotoxicity is vital for clinical practice and public health messaging.

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