UMEM Educational Pearls

Category: Cardiology

Title: cocaine effects on the heart

Keywords: cocaine (PubMed Search)

Posted: 7/1/2012 by Amal Mattu, MD (Updated: 12/10/2023)
Click here to contact Amal Mattu, MD

[Pearls provided by Dr. Semhar Tewelde]

1. causes systolic and diastolic dysfunction, arrhythmias, and atherosclerosis even in young users with relatively few cardiac risk factors, typically TIMI risk score <1

2. decreases myocardial contractility and ejection fraction by blocking sodium and potassium channels within the myocardium

3. prolongs the PR, QRS, and QT intervals on the ECG

4. users have a higher overall incidence of MI (odds ratio 3.8 to 6.9)

5. -induced chest pain is associated with acute MI in approx. 6% of cases

6. increases the risk of MI by 24-fold in the first hour after use

7. contributes to approx. 1 of every 4 MIs  between 18 and 45 years of age



Cardiovascular Effects of Cocaine.  Schwartz B, et al. Circulation. 2010;122:2558-2569.