The heart in cocaine dependence
| The heart in cocaine dependence | |
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| The heart in cocaine dependence: Gross, focal scars in myocardium, a woman in twenties with sudden death Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Cocaine can cause coronary artery spasms which may lead to a myocardial infarction. This effect can happen randomly to any user. The coronary artery spasms can occur on the user's first usage or any other usage after. The coronary spasms cause the ectopic ventricular foci of the heart to become hypoxic and the extreme irritability can trigger life-threatening ventricular arrhythmias. [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11]
Pathological Findings
Gross Images
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Heart: Cocaine dependence: Gross, focal scars in myocardium, a woman in twenties with sudden death.
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Heart: Cocaine dependence: Gross, focal scars in myocardium, a woman in twenties with sudden death.
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Heart: Cocaine dependence: Gross, focal scars in myocardium, a woman in twenties with sudden death.
Microscopic Images
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Heart: Cocaine dependence: Micro low mag H&E scar in myocardium woman in twenties sudden death
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Heart: Cocaine dependence: Micro med mag small artery in myocardium with marked intimal thickening questionable evidence of previous injury due to spasm. Specimen taken from a woman in twenties after sudden death.
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Heart: Cocaine dependence: Micro high mag small artery in myocardium with marked intimal thickening and vacuolated smooth muscle cells in media questionable evidence of previous spasm woman in twenties sudden death
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Heart: Cocaine dependence: Micro low mag scars in myocardium. Specimen taken from a woman in twenties after sudden death.
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Heart: Cocaine dependence: Micro, high mag, H&E, small artery in epicardium with vacuolated medial smooth muscle cells possible evidence of previous spasm. Specimen taken from a woman in twenties after sudden death.
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Heart: Cocaine dependence: Micro, high mag, H&E, small artery in epicardium with vacuolated medial smooth muscle cells possible evidence of previous spasm. Specimen taken from a woman in twenties after sudden death.
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Micro, med mag small, myocardial artery intimal thickening due to vasospasm. Specimen taken from a woman in twenties after sudden death.
References
- ↑ Virmani R. Cocaine-associated cardiovascular disease: clinical and pathological aspects. NIDA Res Monogr 1991;108:220–9
- ↑ Lange RA, Hillis LD. Cardiovascular complications of cocaine use. N Engl J Med 2001;345:351– 8.
- ↑ Rump AF, Theisohn M, Klaus W. The pathophysiology of cocaine cardiotoxicity. Forensic Sci Int 1995;71:103–15.
- ↑ Brickner ME, Willard JE, Eichhorn EJ, et al. Left ventricular hypertrophy associated with chronic cocaine abuse. Circulation 1991;84:1130–5.
- ↑ Majid PA, Patel B, Kim HS, et al. An angiographic and histologic study of cocaine-induced chest pain. Am J Cardiol 1990;65:812–4.
- ↑ Hollander JE. The management of cocaine-associated myocardial ischemia. N Engl J Med 1995;333:1267–72.
- ↑ Mouhaffel AH, Madu EC, Satmary WA, et al. Cardiovascular complications of cocaine. Chest 1995;107:1426–34.
- ↑ Perrone J, Hollander JE, De Roos F. Cardiovascular risk factors and atherosclerosis in children and young adults. N Engl J Med 1998;339:1083–4.
- ↑ Kloner RA, Hale S, Alker K, et al. The effects of acute and chronic cocaine use on the heart. Circulation 1992;85:407–19.
- ↑ Kolodgie FD, Wilson PS, Mergner WJ, et al. Cocaine-induced increase in the permeability function of human vascular endothelial cell monolayers. Exp Mol Pathol 1999;66:109–22.
- ↑ Schindler CW. Cocaine and cardiovascular toxicity. Addict Biol 1996;1:31–47.