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Unique Identifier 97390699
Authors: Pitts WR. Lange RA. Cigarroa JE. Hillis LD.
Institution: Department of Internal Medicine (Cardiovascular Division), University ofTexas Southwestern Medical Center, Dallas 75235-9047, USA.
Title: Cocaine-induced myocardial ischemia and infarction: pathophysiology,recognition, and management. [Review] [88 refs]
Source: Progress in Cardiovascular Diseases. 40(1):65-76, 1997 Jul-Aug.
Abstract: As cocaine abuse has become widespread, it has been associated with variouscardiovascular complications, including angina pectoris, myocardialinfarction, and sudden cardiac death. Cocaine's principal effects on thecardiovascular system are mediated via alpha-adrenergic stimulation andinclude (1) an increase in the determinants of myocardial oxygen demand(heart rate and systemic arterial pressure), and (2) a concomitant decreasein myocardial oxygen supply (caused by vasoconstriction of the epicardialcoronary arteries). beta-adrenergic blocking agents may exacerbatecocaine-induced coronary arterial vasoconstriction, thereby increasing themagnitude of myocardial ischemia. In contrast, nitroglycerin and verapamilreverse cocaine-induced hypertension and coronary arterial vasoconstriction;therefore, they are the agents of choice in treating patients withcocaine-associated chest pain. [References: 88]

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