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Cocaine-Associated Chest Pain

Management of cardiovascular emergencies due to cocaine use.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kardiyoloji department. Book Appointment →

What is Cocaine-Associated Chest Pain?

Through its potent sympathomimetic effect, cocaine can cause coronary vasospasm, thrombosis, hypertension, and tachycardia, leading to acute coronary syndrome. Beta-blocker use can worsen coronary vasospasm and is contraindicated.

Benzodiazepines and nitroglycerin are first-line treatment. Phentolamine (alpha blocker) is used in refractory hypertension and vasospasm. Cardiovascular events can develop hours after cocaine use.

Symptoms

Chest pain (minutes to hours after cocaine use)
Hypertension and tachycardia
Sweating and agitation
Shortness of breath
Syncope or cardiac arrest

Risk Factors

Cocaine use (any route — inhalation, IV, nasal)
Young age group (20-40 years)
Underlying coronary artery disease
Concomitant smoking

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Chest pain after cocaine use — EMERGENCY
  • Hypertensive crisis
  • Arrhythmia or cardiac arrest
  • Suspected aortic dissection (tearing pain)

Treatment Methods

01
Benzodiazepine (diazepam or midazolam — first line)
02
Nitroglycerin (treatment of coronary vasospasm)
03
Aspirin
04
Phentolamine (alpha blocker — in refractory hypertension)
05
Beta blocker CONTRAINDICATED (risk of unopposed alpha stimulation)
06
Coronary angiography (in STEMI pattern)

Which Department to Visit?

You can visit our Kardiyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.