• Emerg. Med. Clin. North Am. · Nov 2005

    Review

    Cocaine-associated chest pain.

    • Joel T Levis and Gus M Garmel.
    • Kaiser Santa Clara Medical Center, Department of Emergency Medicine, CA 95051, USA. joel.levis@kp.org
    • Emerg. Med. Clin. North Am. 2005 Nov 1;23(4):1083-103.

    AbstractCurrent estimates establish that more than 30 million people in the United States use cocaine. Cardiovascular complaints commonly occur among patients who present to emergency departments(EDs) after cocaine use, with chest pain the most common complaint in several studies. Although myocardial ischemia and infarction account for only a small percentage of cocaine-associated chest-pain, physicians must understand the pathophysiology of cocaine and appropriate diagnostic and treatment strategies to best manage these patients and minimize adverse outcomes. This article reviews the pharmacology of cocaine, its role in the pathogenesis of chest pain with specific emphasis on inducing myocardial ischemia and infarction, and current diagnostic and management strategies for cocaine-associated chest pain encountered in the ED.

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