Cocaine may cause Chest Pain in Young Patients

Cocaine use may be a cause of chest pain and similar symptoms in young or otherwise healthy patients, a new report released by the American Heart Association (AHA) revealed on Monday.

The physicians should ask their patients as to whether or not they have used cocaine in the past if they complain of chest pain. Cocaine use can also have a major impact on treatment of heart attack patients. Two standard heart attack treatments, beta-blockers and clot-busting drugs, can be dangerous if a patient has been using cocaine.

The AHA report suggests that besides chest pain, the cocaine use can cause shortness of breath, anxiety, palpitations, dizziness, nausea and heavy sweating, which all are symptoms of a heart attack.

In addition, it can also result in increased blood pressure that can increase the risk of bleeding into the brain when a patient is given clot-busting drugs. Usually, clot-busting drugs and beta-blockers can lower blood pressure without constricting the arteries of typical heart attack patients, but they can cause higher blood pressure and constricted arteries in people who've used cocaine.

According to the new guidelines published online Monday in the American Heart Association journal Circulation, younger patients with no heart disease risk factors should be asked when they reach at hospital emergency rooms if they have used cocaine. Cocaine users with chest pain should be kept under observation for nine to 12 hours, the new guidelines recommend.

"Not knowing what you are dealing with and giving the wrong therapies could mean death rather than benefit," said Dr. James Reiffel, professor of clinical medicine at Columbia University Medical Center/New York Presbyterian Hospital.

As per the report, on most occasions chest pain related to cocaine use occurred within three hours of using the drug. The report also stated that from 1999 to 2002, the number of cocaine-related emergency room visits rose by 47%, and the majority of these visits are of younger people, around the age of 35.

"More commonly, these are younger people. The most common age group is about 35 to 44 for patients who come to the emergency department after cocaine use, having chest pain," said Dr. James McCord, cardiology director of the chest pain unit of the Henry Ford Medical System in Detroit who headed the panel that drafted the report.

The latest data from government's Substance Abuse and Mental Health Services Administration shows that the number of cocaine-related users visiting emergency rooms rose 47 percent from 1995 to 2002, increasing from 135,711 to 199,198.

The AHA report states that cocaine accounts for more than 100 000 emergency-department visits in the US every year.

The report also addresses the issue of stenting, a treatment used to prop open the critical blood vessel. The statement recommends that cocaine users with a coronary artery blockage should get a bare metal stent instead of a drug-coated or medicated stent since long-term cocaine users may not reliably take the medication needed to prevent drug-eluting stents from becoming blocked.