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01-01-2009 | Review Article

Cardiovascular complications of cocaine: Imaging findings

Authors: Carlos S. Restrepo, Carlos A. Rojas, Santiago Martinez, Roy Riascos, Alejandro Marmol-Velez, Jorge Carrillo, Daniel Vargas

Published in: Emergency Radiology | Issue 1/2009

Abstract

Cocaine is the second most commonly abused illicit drug in the US and the most common one involved in emergency department visits, the majority of which are related to the cardiovascular system. Cardiovascular complications related with cocaine abuse include myocardial ischemia and infarction, myocarditis, hypertrophic cardiomyopathy, dilated cardiomyopathy, aortic dissection, thrombosis, stroke and cerebral hemorrhage, and different forms of visceral ischemia, among others. In an era where cocaine use has reached epidemic proportions, it is necessary for the radiologist to understand the pathophysiology, clinical presentation, and imaging characteristics of its cardiovascular complications.

Services UDoHaH. Substance Abuse and Mental Health Services Administration, Results from the 2005 National Survey on Drug Use and Health: National Findings, 2006

Restrepo CS, Carrillo JA, Martinez S et al (2007) Pulmonary complications from cocaine and cocaine-based substances: imaging manifestations. Radiographics 27:941–956. doi:10.1148/rg.274065144 PubMedCrossRef

Services UDoHaH. Monitoring the Future. Substance Abuse and Mental Health Services Administration, Results from the 2005 National Survey on Drug Use and Health: National Findings. 2006

Brody SL, Slovis CM, Wrenn KD (1990) Cocaine-related medical problems: consecutive series of 233 patients. Am J Med 88:325–331. doi:10.1016/0002-9343(90)90484-U PubMedCrossRef

Shannon M (1988) Clinical toxicity of cocaine adulterants. Ann Emerg Med 17:1243–1247. doi:10.1016/S0196-0644(88)80078-7 PubMedCrossRef

Kloner RA, Hale S, Alker K et al (1992) The effects of acute and chronic cocaine use on the heart. Circulation 85:407–419PubMed

Billman GE (1990) Mechanisms responsible for the cardiotoxic effects of cocaine. FASEB J 4:2469–2475PubMed

Frishman WH, Del Vecchio A, Sanal S et al (2003) Cardiovascular manifestations of substance abuse part 1: cocaine. Heart Dis 5:187–201. doi:10.1097/01.hdx.0000074519.43281.fa PubMedCrossRef

Gotway MB, Marder SR, Hanks DK et al (2002) Thoracic complications of illicit drug use: an organ system approach. Radiographics 22(Spec No):S119–S135PubMed

10.

Hagan IG, Burney K (2007) Radiology of recreational drug abuse. Radiographics 27:919–940. doi:10.1148/rg.274065103 PubMedCrossRef

11.

Lange RA, Hillis LD (2001) Cardiovascular complications of cocaine use. N Engl J Med 345:351–358. doi:10.1056/NEJM200108023450507 PubMedCrossRef

12.

Rump AF, Theisohn M, Klaus W (1995) The pathophysiology of cocaine cardiotoxicity. Forensic Sci Int 71:103–115. doi:10.1016/0379-0738(94)01638-L PubMedCrossRef

13.

Billman GE (1994) The effect of adrenergic receptor antagonists on cocaine-induced ventricular fibrillation: alpha but not beta adrenergic receptor antagonists prevent malignant arrhythmias independent of heart rate. J Pharmacol Exp Ther 269:409–416PubMed

14.

Billman GE (1995) Cocaine: a review of its toxic actions on cardiac function. Crit Rev Toxicol 25:113–132. doi:10.3109/10408449509021610 PubMedCrossRef

15.

Mo W, Singh AK, Arruda JA et al (1998) Role of nitric oxide in cocaine-induced acute hypertension. Am J Hypertens 11:708–714. doi:10.1016/S0895-7061(98)00041-7 PubMedCrossRef

16.

Wilbert-Lampen U, Seliger C, Zilker T et al (1998) Cocaine increases the endothelial release of immunoreactive endothelin and its concentrations in human plasma and urine: reversal by coincubation with sigma-receptor antagonists. Circulation 98:385–390PubMed

17.

Perera R, Kraebber A, Schwartz MJ (1997) Prolonged QT interval and cocaine use. J Electrocardiol 30:337–339. doi:10.1016/S0022-0736(97)80047-7 PubMedCrossRef

18.

Perreault CL, Morgan KG, Morgan JP (1991) Effects of cocaine on intracellular calcium handling in cardiac and vascular smooth muscle. NIDA Res Monogr 108:139–153PubMed

19.

Billman GE, Hoskins RS (1988) Cocaine-induced ventricular fibrillation: protection afforded by the calcium antagonist verapamil. FASEB J 2:2990–2995PubMed

20.

Boghdadi MS, Henning RJ (1997) Cocaine: pathophysiology and clinical toxicology. Heart Lung 26:466–483. Quiz 484–485. doi:10.1016/S0147-9563(97)90040-6 PubMedCrossRef

21.

Webber J, Kline RA, Lucas CE (1999) Aortic thrombosis associated with cocaine use: report of two cases. Ann Vasc Surg 13:302–304. doi:10.1007/s100169900261 PubMedCrossRef

22.

Mirzayan R, Hanks SE, Weaver FA (1998) Cocaine-induced thrombosis of common iliac and popliteal arteries. Ann Vasc Surg 12:476–481. doi:10.1007/s100169900188 PubMedCrossRef

23.

Qureshi AI, Suri MF, Guterman LR et al (2001) Cocaine use and the likelihood of nonfatal myocardial infarction and stroke: data from the Third National Health and Nutrition Examination Survey. Circulation 103:502–506PubMed

24.

Moliterno DJ, Willard JE, Lange RA et al (1994) Coronary-artery vasoconstriction induced by cocaine, cigarette smoking, or both. N Engl J Med 330:454–459. doi:10.1056/NEJM199402173300702 PubMedCrossRef

25.

Randall T (1992) Cocaine, alcohol mix in body to form even longer lasting, more lethal drug. JAMA 267:1043–1044. doi:10.1001/jama.267.8.1043 PubMedCrossRef

26.

Hearn WL, Rose S, Wagner J et al (1991) Cocaethylene is more potent than cocaine in mediating lethality. Pharmacol Biochem Behav 39:531–533. doi:10.1016/0091-3057(91)90222-N PubMedCrossRef

27.

Gitter MJ, Goldsmith SR, Dunbar DN et al (1991) Cocaine and chest pain: clinical features and outcome of patients hospitalized to rule out myocardial infarction. Ann Intern Med 115:277–282PubMed

28.

Hollander JE, Hoffman RS, Gennis P et al (1994) Prospective multicenter evaluation of cocaine-associated chest pain. Cocaine Associated Chest Pain (COCHPA) Study Group. Acad Emerg Med 1:330–339PubMed

29.

Chakko S, Fernandez A, Mellman TA et al (1992) Cardiac manifestations of cocaine abuse: a cross-sectional study of asymptomatic men with a history of long-term abuse of “crack” cocaine. J Am Coll Cardiol 20:1168–1174PubMed

30.

Hollander JE, Vignona L, Burstein J (1997) Predictors of underlying coronary artery disease in cocaine associated myocardial infarction: a meta-analysis of case reports. Vet Hum Toxicol 39:276–280PubMed

31.

Minor RL Jr, Scott BD, Brown DD et al (1991) Cocaine-induced myocardial infarction in patients with normal coronary arteries. Ann Intern Med 115:797–806PubMed

32.

Kolodgie FD, Virmani R, Cornhill JF et al (1991) Increase in atherosclerosis and adventitial mast cells in cocaine abusers: an alternative mechanism of cocaine-associated coronary vasospasm and thrombosis. J Am Coll Cardiol 17:1553–1560PubMed

33.

Satran A, Bart BA, Henry CR et al (2005) Increased prevalence of coronary artery aneurysms among cocaine users. Circulation 111:2424–2429. doi:10.1161/01.CIR.0000165121.50527.DE PubMedCrossRef

34.

Wiener RS, Lockhart JT, Schwartz RG (1986) Dilated cardiomyopathy and cocaine abuse. Report of two cases. Am J Med 81:699–701. doi:10.1016/0002-9343(86)90559-0 PubMedCrossRef

35.

Willens HJ, Chakko SC, Kessler KM (1994) Cardiovascular manifestations of cocaine abuse. A case of recurrent dilated cardiomyopathy. Chest 106:594–600. doi:10.1378/chest.106.2.594 PubMedCrossRef

36.

Afonso L, Mohammad T, Thatai D (2007) Crack whips the heart: a review of the cardiovascular toxicity of cocaine. Am J Cardiol 100:1040–1043. doi:10.1016/j.amjcard.2007.04.049 PubMedCrossRef

37.

Arora S, Alfayoumi F, Srinivasan V (2006) Transient left ventricular apical ballooning after cocaine use: is catecholamine cardiotoxicity the pathologic link. Mayo Clin Proc 81:829–832PubMedCrossRef

38.

Tazelaar HD, Karch SB, Stephens BG et al (1987) Cocaine and the heart. Hum Pathol 18:195–199. doi:10.1016/S0046-8177(87)80338-6 PubMedCrossRef

39.

Ren S, Tong W, Lai H et al (2006) Effect of long-term cocaine use on regional left ventricular function as determined by magnetic resonance imaging. Am J Cardiol 97:1085–1088. doi:10.1016/j.amjcard.2005.10.056 PubMedCrossRef

40.

Brickner ME, Willard JE, Eichhorn EJ et al (1991) Left ventricular hypertrophy associated with chronic cocaine abuse. Circulation 84:1130–1135PubMed

41.

Corral Ansa L, Manuel Galvan J, Ferrer Sierra MJ (2001) Balloon counterpulsation in cocaine induced cardiomyopathy. Med Clin (Barc) 116:559

42.

Duell PB (1987) Chronic cocaine abuse and dilated cardiomyopathy. Am J Med 83:601. doi:10.1016/0002-9343(87)90784-4 PubMedCrossRef

43.

Billman GE, Lappi MD (1993) Effects of cocaine on cardiac vagal tone before and during coronary artery occlusion: cocaine exacerbates the autonomic response to myocardial ischemia. J Cardiovasc Pharmacol 22:869–876PubMedCrossRef

44.

McCrohon JA, Moon JC, Prasad SK et al (2003) Differentiation of heart failure related to dilated cardiomyopathy and coronary artery disease using gadolinium-enhanced cardiovascular magnetic resonance. Circulation 108:54–59. doi:10.1161/01.CIR.0000078641.19365.4C PubMedCrossRef

45.

Vogel-Claussen J, Rochitte CE, Wu KC et al (2006) Delayed enhancement MR imaging: utility in myocardial assessment. Radiographics 26:795–810. doi:10.1148/rg.263055047 PubMedCrossRef

46.

Chambers HF, Morris DL, Tauber MG et al (1987) Cocaine use and the risk for endocarditis in intravenous drug users. Ann Intern Med 106:833–836PubMed

47.

Virmani R, Robinowitz M, Smialek JE et al (1988) Cardiovascular effects of cocaine: an autopsy study of 40 patients. Am Heart J 115:1068–1076. doi:10.1016/0002-8703(88)90078-6 PubMedCrossRef

48.

Hsue PY, Salinas CL, Bolger AF et al (2002) Acute aortic dissection related to crack cocaine. Circulation 105:1592–1595. doi:10.1161/01.CIR.0000012524.44897.3A PubMedCrossRef

49.

Eagle KA, Isselbacher EM, DeSanctis RW (2002) Cocaine-related aortic dissection in perspective. Circulation 105:1529–1530PubMed

50.

Singh S, Trivedi A, Adhikari T et al (2007) Cocaine-related acute aortic dissection: patient demographics and clinical outcomes. Can J Cardiol 23:1131–1134PubMed

51.

Rashid J, Eisenberg MJ, Topol EJ (1996) Cocaine-induced aortic dissection. Am Heart J 132:1301–1304. doi:10.1016/S0002-8703(96)90486-X PubMedCrossRef

52.

Neri E, Toscano T, Massetti M et al (2001) Cocaine-induced intramural hematoma of the ascending aorta. Tex Heart Inst J 28:218–219PubMed

53.

Treadwell SD, Robinson TG (2007) Cocaine use and stroke. Postgrad Med J 83:389–394. doi:10.1136/pgmj.2006.055970 PubMedCrossRef

54.

Zandio B, Erro M, Cabada T et al (2008) Cocaine-induced brain stem stroke associated to cranial midline destructive lesions. Neurologia 23:55–58

55.

Wallace EA, Wisniewski G, Zubal G et al (1996) Acute cocaine effects on absolute cerebral blood flow. Psychopharmacology (Berl) 128:17–20. doi:10.1007/s002130050104 CrossRef

56.

Boco T, Macdonald RL (2004) Absence of acute cerebral vasoconstriction after cocaine-associated subarachnoid hemorrhage. Neurocrit Care 1:449–454. doi:10.1385/NCC:1:4:449 PubMedCrossRef

57.

Levine SR, Brust JC, Futrell N et al (1991) A comparative study of the cerebrovascular complications of cocaine: alkaloidal versus hydrochloride—a review. Neurology 41:1173–1177PubMed

58.

Levine SR, Brust JC, Futrell N et al (1990) Cerebrovascular complications of the use of the “crack” form of alkaloidal cocaine. N Engl J Med 323:699–704PubMed

59.

Brown E, Prager J, Lee HY et al (1992) CNS complications of cocaine abuse: prevalence, pathophysiology, and neuroradiology. AJR Am J Roentgenol 159:137–147PubMed

60.

Rojas R, Riascos R, Vargas D et al (2005) Neuroimaging in drug and substance abuse part I: cocaine, cannabis, and ecstasy. Top Magn Reson Imaging 16:231–238. doi:10.1097/01.rmr.0000192156.46492.24 PubMedCrossRef

61.

Peterson PL, Roszler M, Jacobs I et al (1991) Neurovascular complications of cocaine abuse. J Neuropsychiatry Clin Neurosci 3:143–149PubMed

62.

Strickland TL, Mena I, Villanueva-Meyer J et al (1993) Cerebral perfusion and neuropsychological consequences of chronic cocaine use. J Neuropsychiatry Clin Neurosci 5:419–427PubMed

63.

Ellis CN, McAlexander WW (2005) Enterocolitis associated with cocaine use. Dis Colon Rectum 48:2313–2316. doi:10.1007/s10350-005-0195-5 PubMedCrossRef

64.

Niazi M, Kondru A, Levy J et al (1997) Spectrum of ischemic colitis in cocaine users. Dig Dis Sci 42:1537–1541. doi:10.1023/A:1018839415743 PubMedCrossRef

65.

Osorio J, Farreras N, Ortiz De Zarate L et al (2000) Cocaine-induced mesenteric ischaemia. Dig Surg 17:648–651. doi:10.1159/000051980 PubMedCrossRef

66.

Herskowitz MM, Gillego V, Ward M et al (2002) Cocaine-induced mesenteric ischemia: treatment with intra-arterial papaverine. Emerg Radiol 9:172–174PubMed

67.

Schultz JSB, Sumpio BE, Gusberg RJ (1998) Cocaine-associated myocardial and mesenteric ischemia: a case report and review of the literature. Int J Angiol 7(1):1–5. doi:10.1007/BF01616266 CrossRef

68.

Peterson CM, Menias CO, Balfe DM et al (2006) Adult intussusception due to cocaine-induced bowel wall hematoma: a case study. Emerg Radiol 12:177–179. doi:10.1007/s10140-006-0475-y PubMedCrossRef

69.

Hazanas FH, Torres CP, Delgado FI (1993) Multiorgan failure (MOF) and intestinal ischemia after cocaine intoxication. Intensive Care Med 19:239–240. doi:10.1007/BF01694779 PubMedCrossRef

70.

Bemanian S, Motallebi M, Nosrati SM (2005) Cocaine-induced renal infarction: report of a case and review of the literature. BMC Nephrol 6:10. doi:10.1186/1471-2369-6-10 PubMedCrossRef

71.

Delaney K, Hoffman RS (1991) Pulmonary infarction associated with crack cocaine use in a previously healthy 23-year-old woman. Am J Med 91:92–94. doi:10.1016/0002-9343(91)90080-H PubMedCrossRef

72.

Dettmeyer R, Schlamann M, Madea B (2004) Cocaine-associated abscesses with lethal sepsis after splenic infarction in a 17-year-old woman. Forensic Sci Int 140:21–23. doi:10.1016/j.forsciint.2003.11.031 PubMedCrossRef

73.

Homler HJ (1995) Nontraumatic splenic hematoma related to cocaine abuse. West J Med 163:160–162PubMed

74.

Marder VJ, Mellinghoff IK (2000) Cocaine and Buerger disease: is there a pathogenetic association. Arch Intern Med 160:2057–2060PubMed

75.

Downing GJ, Horner SR, Kilbride HW (1991) Characteristics of perinatal cocaine-exposed infants with necrotizing enterocolitis. Am J Dis Child 145:26–27PubMed

76.

Czyrko C, Del Pin CA, O’Neill JA Jr et al (1991) Maternal cocaine abuse and necrotizing enterocolitis: outcome and survival. J Pediatr Surg 26:414–418. Discussion 419–421.doi:10.1016/0022-3468(91)90988-6 PubMedCrossRef

77.

Yap TE, Diana D, Herson V et al (1994) Fetal myocardial calcification associated with maternal cocaine use. Am J Perinatol 11:179–183PubMedCrossRef

78.

Townsend RR, Laing FC, Jeffrey RB Jr (1988) Placental abruption associated with cocaine abuse. AJR Am J Roentgenol 150:1339–1340PubMed

Title: Cardiovascular complications of cocaine: Imaging findings
Authors: Carlos S. Restrepo
Carlos A. Rojas
Santiago Martinez
Roy Riascos
Alejandro Marmol-Velez
Jorge Carrillo
Daniel Vargas
Publication date: 01-01-2009
Publisher: Springer-Verlag
Published in: Emergency Radiology / Issue 1/2009
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI: https://doi.org/10.1007/s10140-008-0762-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cardiovascular complications of cocaine: Imaging findings

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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