CARDIOVASCULAR EFFECTS OF COCAINE 1. TACHYCARDIA + HYPERTENSION 2. NON ISCHAEMIC CHEST PAIN 3. MYOCARDIAL ISCHAEMIA + INFARCTION 4. CORONARY ARTERY ANEURYSM.

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Presentation transcript:

CARDIOVASCULAR EFFECTS OF COCAINE 1. TACHYCARDIA + HYPERTENSION 2. NON ISCHAEMIC CHEST PAIN 3. MYOCARDIAL ISCHAEMIA + INFARCTION 4. CORONARY ARTERY ANEURYSM + DISSECTION 5. AORTIC DISSECTION 6. DYSRHYTHMIAS Spontaneous LAD dissection COCAINE-ASSOCIATED CHEST PAIN

PATHOPHYSIOLOGY Mayo Clin Proc. Dec 2011; 86(12): 1198–1207.

1. ABCDE LEAD ECG 3. BLOOD TESTS 4. S/L GTN 5. PO ASPIRIN 6. IV DIAZEPAM 7. IV NITRATE INFUSION: for persisting pain (suspected cardiac origin) or evidence of ischaemia on ECG 8. CALCIUM CHANNEL BLOCKERS: consider in patients who do not respond to benzodiazepines and GTN. Caution in LV dysfunction or CCF. 9. PERSISTENT CHEST PAIN + ST ↑ NOT RELIEVED WITH DIAZEPAM, ASPIRIN AND NITRATES  FOLLOW LOCAL PROTOCOL FOR PCI. MANAGEMENT OF CHEST PAIN Mayo Clin Proc. Dec 2011; 86(12): 1198–1207. Circulation. 2008; 117:

AMERICAN HEART ASSOCIATION THERAPEUTIC + DIAGNOSTIC RECOMMENDATIONS Circulation. 2008; 117: