Diseases
Cocaine-induced chest pain should be treated with caution
By Ben Wasserman
Mar 18, 2008 - 9:11:31 AM

TUESDAY March 18, 2008 (Foodconsumer.org) -- The America Heart Association (AHA) released a statement Monday in the journal Circulation to alert doctors that chest pain in young or otherwise healthy patients can sometimes be induced by cocaine use.

Doctors need to make certain whether those with a suspected heart attack have used cocaine because if they did, the treatment should be different, said Dr. James McCord cardiology, director of the chest pain unit of the Henry Ford Medical System in Detroit.

McCord said in a statement cited by healthday.com that two standard treatments for heart attack, beta-blockers and clot-busting drugs can be dangerous to chest pain patients who have been using cocaine.

Cocaine use can increase blood pressure, which increases risk of bleeding into the brain when patients are given clot-busting drugs.

Normally, beta-blockers can lower blood pressure without constricting the arteries of patients who suffer heart attack.  But in people who have used cocaine, beta-blockers have the opposite effects.
 
Cocaine may induce chest pain within three hours of using the drug. But the drug can cause problems for 18 hours because the remnants of the drug remain in the body for such a long period, McCord said.

The statement recommends that since most cocaine-induced chest pain is not a heart attack, cocaine users with chest pain should stay in hospital for nine to 12 hours of observation.

McCord said if the patient with chest pain is unconscious, a drug test can be done at the doctor's discretion.   Otherwise doctors should talk to the patient asking him if he has used cocaine.