cocaine cardiotoxicity
cocaine cardiotoxicity
A generic term for the direct and indirect effects of cocaine on the heart.Clinical findings
Chest pain, tachycardia, hypertension, acute myocardial infarction (MI), ventricular arrhythmia, asystole, congestive heart failure, sudden death due to cardiovascular collapse.
Direct effects
• Arrhythmias Conduction defects
• Acute MI Coronary arterial spasm; intimal hyperplasia.
Indirect effects
• Catecholamine effects Contraction band necrosis, myocardial fibrosis, and arrhythmias.
Pathogenesis
Vasoconstriction and direct cardiac toxicity.
Cocaine, acute effects
Contraction bands and necrosis.
Cocaine, chronic effects
• LV hypertrophy
• Fibrosis—patchy and irregular
• Intramyocardial arterial medial thickening.