Cocaine-induced myocardial ischemia and infarction: Pathophysiology, recognition, and management

W. R. Pitts, R. A. Lange, Joaquin Cigarroa, L. D. Hillis

Research output: Contribution to journalArticle

108 Citations (Scopus)

Abstract

As cocaine abuse has become widespread, it has been associated with various cardiovascular complications, including angina pectoris, myocardial infarction, and sudden cardiac death. Cocaine's principal effects on the cardiovascular system are mediated via α-adrenergic stimulation and include (1) an increase in the determinants of myocardial oxygen demand (heart rate and systemic arterial pressure), and (2) a concomitant decrease in myocardial oxygen supply (caused by vasoconstriction of the epicardial coronary arteries). β-adrenergic blocking agents may exacerbate cocaine-induced coronary arterial vasoconstriction, thereby increasing the magnitude of myocardial ischemia. In contrast, nitroglycerin and verapamil reverse cocaine-induced hypertension and coronary arterial vasoconstriction; therefore, they are the agents of choice in treating patients with cocaine- associated chest pain.

Original languageEnglish (US)
Pages (from-to)65-76
Number of pages12
JournalProgress in Cardiovascular Diseases
Volume40
Issue number1
DOIs
StatePublished - 1997
Externally publishedYes

Fingerprint

Cocaine
Myocardial Ischemia
Vasoconstriction
Myocardial Infarction
Oxygen
Cocaine-Related Disorders
Adrenergic Antagonists
Sudden Cardiac Death
Nitroglycerin
Angina Pectoris
Verapamil
Cardiovascular System
Chest Pain
Adrenergic Agents
Coronary Vessels
Arterial Pressure
Heart Rate
Hypertension

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Cocaine-induced myocardial ischemia and infarction : Pathophysiology, recognition, and management. / Pitts, W. R.; Lange, R. A.; Cigarroa, Joaquin; Hillis, L. D.

In: Progress in Cardiovascular Diseases, Vol. 40, No. 1, 1997, p. 65-76.

Research output: Contribution to journalArticle

@article{4eb7510fb0334e50af81d74c1e85452b,
title = "Cocaine-induced myocardial ischemia and infarction: Pathophysiology, recognition, and management",
abstract = "As cocaine abuse has become widespread, it has been associated with various cardiovascular complications, including angina pectoris, myocardial infarction, and sudden cardiac death. Cocaine's principal effects on the cardiovascular system are mediated via α-adrenergic stimulation and include (1) an increase in the determinants of myocardial oxygen demand (heart rate and systemic arterial pressure), and (2) a concomitant decrease in myocardial oxygen supply (caused by vasoconstriction of the epicardial coronary arteries). β-adrenergic blocking agents may exacerbate cocaine-induced coronary arterial vasoconstriction, thereby increasing the magnitude of myocardial ischemia. In contrast, nitroglycerin and verapamil reverse cocaine-induced hypertension and coronary arterial vasoconstriction; therefore, they are the agents of choice in treating patients with cocaine- associated chest pain.",
author = "Pitts, {W. R.} and Lange, {R. A.} and Joaquin Cigarroa and Hillis, {L. D.}",
year = "1997",
doi = "10.1016/S0033-0620(97)80023-0",
language = "English (US)",
volume = "40",
pages = "65--76",
journal = "Progress in Cardiovascular Diseases",
issn = "0033-0620",
publisher = "W.B. Saunders Ltd",
number = "1",

}

TY - JOUR

T1 - Cocaine-induced myocardial ischemia and infarction

T2 - Pathophysiology, recognition, and management

AU - Pitts, W. R.

AU - Lange, R. A.

AU - Cigarroa, Joaquin

AU - Hillis, L. D.

PY - 1997

Y1 - 1997

N2 - As cocaine abuse has become widespread, it has been associated with various cardiovascular complications, including angina pectoris, myocardial infarction, and sudden cardiac death. Cocaine's principal effects on the cardiovascular system are mediated via α-adrenergic stimulation and include (1) an increase in the determinants of myocardial oxygen demand (heart rate and systemic arterial pressure), and (2) a concomitant decrease in myocardial oxygen supply (caused by vasoconstriction of the epicardial coronary arteries). β-adrenergic blocking agents may exacerbate cocaine-induced coronary arterial vasoconstriction, thereby increasing the magnitude of myocardial ischemia. In contrast, nitroglycerin and verapamil reverse cocaine-induced hypertension and coronary arterial vasoconstriction; therefore, they are the agents of choice in treating patients with cocaine- associated chest pain.

AB - As cocaine abuse has become widespread, it has been associated with various cardiovascular complications, including angina pectoris, myocardial infarction, and sudden cardiac death. Cocaine's principal effects on the cardiovascular system are mediated via α-adrenergic stimulation and include (1) an increase in the determinants of myocardial oxygen demand (heart rate and systemic arterial pressure), and (2) a concomitant decrease in myocardial oxygen supply (caused by vasoconstriction of the epicardial coronary arteries). β-adrenergic blocking agents may exacerbate cocaine-induced coronary arterial vasoconstriction, thereby increasing the magnitude of myocardial ischemia. In contrast, nitroglycerin and verapamil reverse cocaine-induced hypertension and coronary arterial vasoconstriction; therefore, they are the agents of choice in treating patients with cocaine- associated chest pain.

UR - http://www.scopus.com/inward/record.url?scp=0030841005&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030841005&partnerID=8YFLogxK

U2 - 10.1016/S0033-0620(97)80023-0

DO - 10.1016/S0033-0620(97)80023-0

M3 - Article

C2 - 9247556

AN - SCOPUS:0030841005

VL - 40

SP - 65

EP - 76

JO - Progress in Cardiovascular Diseases

JF - Progress in Cardiovascular Diseases

SN - 0033-0620

IS - 1

ER -