Cocaine-induced coronary-artery vasoconstriction

Article Abstract:

In the United States cocaine is commonly used as a topical anesthetic for nasal surgery. Some of the side effects of cocaine may include high blood pressure, heart arrhythmia (abnormal heartbeat rhythm), and increased oxygen demand of the myocardium (heart muscle). In cardiac patients, ischemia (inadequate oxygen supply) or myocardial infarction (heart attack) may be induced by cocaine. Abuse of the drug is also associated with serious cardiac episodes. The effect of intranasal cocaine was observed in 45 patients, aged 36 to 67 years, whose evaluation for chest pain included cardiac catheterization (makes possible clear X-ray imaging of the heart and coronary arteries which supply oxygen to the myocardium). Measurements, taken before and 15 minutes after the intranasal administration of cocaine included: heart rate, arterial pressure (within arteries), blood flow in the coronary sinus (vein that empties into the right atrium), and the diameter of the left coronary artery (supplies the left ventricle). The results of the data indicated that cocaine increased the heart rate and systemic arterial pressure, which resulted in increasing the myocardial demand for oxygen. Simultaneously, cocaine reduced myocardial oxygen supply by decreasing the coronary sinus blood flow. None of these measurements changed after the administration of a saline placebo and there was no difference in the results between patients who were or were not ultimately diagnosed with diseased coronary arteries. Constriction of the coronary artery was relieved by phentolamine, an alpha-adrenergic blocking agent. The metabolic, hemodynamic, and arteriographic findings confirmed that cocaine induced the coronary artery vasoconstriction. Researchers concluded that similar but more serious adverse effects could be anticipated with higher doses of cocaine which are typical in recreational use of the drug.

Abnormalities, Causes of, Physiological aspects, Coronary arteries, Vasoconstriction

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Immediate angioplasty for acute myocardial infarction

Article Abstract:

Immediate angioplasty may be more effective than thrombolytic therapy for treatment of patients who have suffered a heart attack. Thrombolytic therapy involves the use of drugs to break up a blood clot. A Q-wave heart attack is caused by a blood clot that blocks the coronary artery. Thrombolytic therapy improves survival of patients who have suffered a heart attack, but some patients may suffer re-occlusion, or blockage, of the artery involved in their original heart attack. Three different research studies compared the use of immediate angioplasty or thrombolytic therapy to treat patients within 12 to 24 hours of the onset of a heart attack. Immediate angioplasty was more effective than thrombolytic therapy in opening the blood vessel involved in the heart attack and in preventing another heart attack. One major drawback of angioplasty is its restricted availability.

Care and treatment, Editorial, Usage, Heart attack, Angioplasty

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Cardiovascular complications of cocaine use

Article Abstract:

Cocaine probably causes cardiac pain and heart attack by increasing the heart's need for oxygen at the same time it constricts the coronary arteries and blocks the supply of oxygen to the heart. Long-term cocaine use can cause heart enlargement and a heart disease called cardiomyopathy, as well as arrhythmias, endocarditis, and aortic dissection.

Heart

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