American Journal of Cardiovascular Drugs

, Volume 9, Issue 3, pp 177–196 | Cite as

Cocaine Cardiotoxicity

A Review of the Pathophysiology, Pathology, and Treatment Options
  • Katharine Phillips
  • Adriana Luk
  • Gursharan S. Soor
  • Jonathan R. Abraham
  • Shaun Leong
  • Jagdish ButanyEmail author
Review Article


Cocaine is a powerful stimulant that gives users a temporary sense of euphoria, mental alertness, talkativeness, and a decreased need for food and sleep. Cocaine intoxication is the most frequent cause of drug-related death reported by medical examiners in the US, and these events are most often related to the cardiovascular manifestations of the drug. Once playing a vital role in medicine as a local anesthetic, decades of research have established that cocaine has the ability to cause irreversible structural damage to the heart, greatly accelerate cardiovascular disease, and initiate sudden cardiac death. Although pathologic findings are often reported in the literature, few images are available to support these findings, and reviews of cocaine cardiopathology are rare. We describe the major pathologic findings linked to cocaine abuse in earlier research, their underlying mechanisms, and the treatment approaches currently being used in this patient population.

A MEDLINE search was conducted to identify all English language articles from January 2000 to June 2008 with the subject headings and key words ‘cocaine’, ‘heart’, ‘toxicity’, and ‘cardiotoxicity’. Epidemiologic, laboratory, and clinical studies on the pathology, pathophysiology, and pharmacology of the effects of cocaine on the heart were reviewed, along with relevant treatment options. Reference lists were used to identify earlier studies on these topics, and related articles from Google Scholar were also included.

There is an established connection between cocaine use and myocardial infarction (MI), arrhythmia, heart failure, and sudden cardiac death. Numerous mechanisms have been postulated to explain how cocaine contributes to these conditions. Among these, cocaine may lead to MI by causing coronary artery vasoconstriction and accelerated atherosclerosis, and by initiating thrombus formation. Cocaine has also been shown to block K+ channels, increase L-type Ca2+ channel current, and inhibit Na+ influx during depolarization, all possible causes for arrhythmia. Additionally, cocaine use has been associated with left ventricular hypertrophy, myocarditis, and dilated cardiomyopathy, which can lead to heart failure if drug use is continued.

Certain diagnostic tools, including ECG and serial cardiac markers, are not as accurate in identifying MI in cocaine users experiencing chest pain. As a result, clinicians should be suspicious of cocaine use in their differential diagnosis of chest pain, especially in the younger male population, and proceed more cautiously when use is suspected.

Treatment for cocaine-related cardiovascular disease is in many ways similar to treatment for traditional cardiovascular disease. However use of β-receptor antagonists and class Ia and III anti-arrhythmics is strongly discouraged if the patient is likely to continue cocaine use, because of documented adverse effects.

The medical community is in urgent need of a pharmacologic adjunct to cocaine-dependence treatment that can deter relapse and reduce the risks associated with cardiovascular disease in these patients.


Cocaine Sudden Cardiac Death Carvedilol Aortic Dissection Therapeutic Hypothermia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review. The authors wish to acknowledge the assistance of the Forensic Pathology Service, Ministry of the Solicitor General, Government of Ontario, Toronto, for illustration materials, and the generous support of the Department of Pathology, University Health Network (Toronto General Hospital), Toronto. The authors also wish to acknowledge Melissa Skarban, Department of Pathology, University Health Network (Toronto General Hospital), Toronto, for her valuable assistance in preparing this manuscript.


  1. 1.
    Grinspoon L, Bakalar JB. Coca and cocaine as medicines: an historical review. J Ethnopharmacol 1981 Mar–May; 3 (2–3): 149–59.PubMedCrossRefGoogle Scholar
  2. 2.
    National Institute on Drug Abuse. Cocaine abuse and addiction. Bethesda (MD): National Institute of Health, 2004 Nov. Report no.: NIH-99-4342.Google Scholar
  3. 3.
    Jeri FR. Coca-paste smoking in some Latin American countries: a severe and unabated form of addiction. Bull Narc 1984 Apr–Jun; 36 (2): 15–31.PubMedGoogle Scholar
  4. 4.
    Cornish JW, O’Brien CP. Crack cocaine abuse: an epidemic with many public health consequences. Annu Rev Public Health 1996; 17: 259–73.PubMedCrossRefGoogle Scholar
  5. 5.
    Billman GE. Mechanisms responsible for the cardiotoxic effects of cocaine. Faseb J 1990 May; 4 (8): 2469–75.PubMedGoogle Scholar
  6. 6.
    Farrar HC, Kearns GL. Cocaine: clinical pharmacology and toxicology. J Pediatr 1989 Nov; 115 (5 Pt 1): 665–75.PubMedCrossRefGoogle Scholar
  7. 7.
    Jones RT. The pharmacology of cocaine smoking in humans. In: Chiang CN, Hawks RL, editors. NIDA Research Monograph 99: research findings of smoking of abused substances. Washington, DC: United States Government Printing Office, 1990: 30–41.Google Scholar
  8. 8.
    Ellenhorn MJ, Barceloux DG, editors. Medical toxicology: diagnosis and treatment of human poisoning. New York: Elsevier, 1988.Google Scholar
  9. 9.
    Chow MJ, Ambre JJ, Ruo TI, et al. Kinetics of cocaine distribution, elimination, and chronotropic effects. Clin Pharmacol Ther 1985 Sep; 38 (3): 318–24.PubMedCrossRefGoogle Scholar
  10. 10.
    Hollander JE, Henry TD. Evaluation and management of the patient who has cocaine-associated chest pain. Cardiol Clin 2006 Feb; 24 (1): 103–14.PubMedCrossRefGoogle Scholar
  11. 11.
    Cone EJ, Tsadik A, Oyler J, et al. Cocaine metabolism and urinary excretion after different routes of administration. Ther Drug Monit 1998 Oct; 20 (5): 556–60.PubMedCrossRefGoogle Scholar
  12. 12.
    Vitti T, Boni R. Metabolism of cocaine. In: Barnett G, Chiang CN, editors. Pharmacokinetics and pharmacodynamics of psychoactive drugs: a research monograph. Foster City (CA): Biomedical Publications, 1985: 427–40.Google Scholar
  13. 13.
    Javaid JI, Musa MN, Fischman M, et al. Kinetics of cocaine in humans after intravenous and intranasal administration. Biopharm Drug Dispos 1983 Jan–Mar; 4(1): 9–18.PubMedCrossRefGoogle Scholar
  14. 14.
    Barnett G, Hawks R, Resnick R. Cocaine pharmacokinetics in humans. J Ethnopharmacol 1981 Mar–May; 3 (2–3): 353–66.PubMedCrossRefGoogle Scholar
  15. 15.
    Ambre JJ, Belknap SM, Nelson J, et al. Acute tolerance to cocaine in humans. Clin Pharmacol Ther 1988 Jul; 44 (1): 1–8.PubMedCrossRefGoogle Scholar
  16. 16.
    Fendrich M, Johnson TP, Sudman S, et al. Validity of drug use reporting in a high-risk community sample: a comparison of cocaine and heroin survey reports with hair tests. Am J Epidemiol 1999 May 15; 149 (10): 955–62.PubMedCrossRefGoogle Scholar
  17. 17.
    Moeller KE, Lee KC, Kissack JC. Urine drug screening: practical guide for clinicians. Mayo Clin Proc 2008 Jan; 83 (1): 66–76.PubMedCrossRefGoogle Scholar
  18. 18.
    Baker JE, Jenkins AJ. Screening for cocaine metabolite fails to detect an intoxication. Am J Forensic Med Pathol 2008 Jun; 29 (2): 141–4.PubMedCrossRefGoogle Scholar
  19. 19.
    Bush DM. The U.S. mandatory guidelines for federal workplace drug testing programs: current status and future considerations. Forensic Sci Int 2008 Jan 30; 174(2–3): 111–9.PubMedCrossRefGoogle Scholar
  20. 20.
    United Nations Office on Drugs and Crime. World Drug Report. Vienna: United Nations, 2008.Google Scholar
  21. 21.
    McCord J, Jneid H, Hollander JE, et al. Management of cocaine-associated chest pain and myocardial infarction: a scientific statement from the American Heart Association Acute Cardiac Care Committee of the Council on Clinical Cardiology. Circulation 2008 Apr 8; 117 (14): 1897–907.PubMedCrossRefGoogle Scholar
  22. 22.
    Mittleman MA, Mintzer D, Maclure M, et al. Triggering of myocardial infarction by cocaine. Circulation 1999 Jun 1; 99 (21): 2737–41.PubMedCrossRefGoogle Scholar
  23. 23.
    Substance Abuse and Mental Health Services Administration, Office of Applied Studies. Emergency department trends from the drug abuse warning network, final estimates, 1995–2002. Rockville (MD): United States Department of Health and Human Services, 2003. Report no.: DAWN Series: D-24, DHHS Publication No. (SMA) 03-3780.Google Scholar
  24. 24.
    White SM, Lambe CJ. The pathophysiology of cocaine abuse. J Clin Forensic Med 2003 Mar; 10(1): 27–39.PubMedCrossRefGoogle Scholar
  25. 25.
    Weber JE, Chudnofsky CR, Boczar M, et al. Cocaine-associated chest pain: how common is myocardial infarction? Acad Emerg Med 2000 Aug; 7 (8): 873–7.PubMedCrossRefGoogle Scholar
  26. 26.
    Drug Abuse Warning Network, 2005. National estimates of drug-related emergency department visits. Rockville (MD): United States Department of Health and Human Services, 2007. DAWN Series D-29, DHHS Publication No. (SMA) 07-4256.Google Scholar
  27. 27.
    Darke S, Kaye S, Duflou J. Cocaine-related fatalities in New South Wales, Australia 1993–2002. Drug Alcohol Depend 2005 Feb 14; 77 (2): 107–14.PubMedCrossRefGoogle Scholar
  28. 28.
    Reynolds M, Pinto D, Josephson M. Sudden cardiac death. In: Fuster V, O’Rourke R, Walsh R, et al., editors. Hurst’s the heart. 12th ed. New York (NY): McGraw-Hill Medical, 2008: 1161–86.Google Scholar
  29. 29.
    Karch SB. Cocaine cardiovascular toxicity. South Med J 2005 Aug; 98 (8): 794–9.PubMedCrossRefGoogle Scholar
  30. 30.
    Blaho K, Logan B, Winbery S, et al. Blood cocaine and metabolite concentrations, clinical findings, and outcome of patients presenting to an ED. Am J Emerg Med 2000 Sep; 18 (5): 593–8.PubMedCrossRefGoogle Scholar
  31. 31.
    Frishman WH, Del Vecchio A, Sanal S, et al. Cardiovascular manifestations of substance abuse part 1: cocaine. Heart Dis 2003 May–Jun; 5 (3): 187–201.PubMedCrossRefGoogle Scholar
  32. 32.
    Feldman JA, Fish SS, Beshansky JR, et al. Acute cardiac ischemia in patients with cocaine-associated complaints: results of a multicenter trial. Ann Emerg Med 2000 Nov; 36 (5): 469–76.PubMedGoogle Scholar
  33. 33.
    Tokarski GF, Paganussi P, Urbanski R, et al. An evaluation of cocaineinduced chest pain. Ann Emerg Med 1990 Oct; 19 (10): 1088–92.PubMedCrossRefGoogle Scholar
  34. 34.
    American Heart Association. Heart disease and stroke statistics: 2008 update. Dallas (TX): American Heart Association, 2008.Google Scholar
  35. 35.
    Benzaquen BS, Cohen V, Eisenberg MJ. Effects of cocaine on the coronary arteries. Am Heart J 2001 Sep; 142 (3): 402–10.PubMedCrossRefGoogle Scholar
  36. 36.
    Lange RA, Cigarroa JE, Hillis LD. Theodore E. Woodward award: cardiovascular complications of cocaine abuse. Trans Am Clin Climatol Assoc 2004; 115:99–114.PubMedGoogle Scholar
  37. 37.
    Lange RA, Cigarroa RG, Yancy Jr CW, et al. Cocaine-induced coronary-artery vasoconstriction. N Engl J Med 1989 Dec 7; 321 (23): 1557–62.PubMedCrossRefGoogle Scholar
  38. 38.
    Moliterno DJ, Willard JE, Lange RA, et al. Coronary-artery vasoconstriction induced by cocaine, cigarette smoking, or both. N Engl J Med 1994 Feb 17; 330 (7): 454–9.PubMedCrossRefGoogle Scholar
  39. 39.
    Schiffrin EL. Role of endothelin-1 in hypertension and vascular disease. Am J Hypertens 2001 Jun; 14 (6 Suppl.): 83S–9S.PubMedCrossRefGoogle Scholar
  40. 40.
    Masson S, Latini R, Anand IS, et al. The prognostic value of big endothelin-1 in more than 2,300 patients with heart failure enrolled in the Valsartan Heart Failure Trial (Val-HeFT). J Card Fail 2006 Jun; 12 (5): 375–80.PubMedCrossRefGoogle Scholar
  41. 41.
    Fandino J, Sherman JD, Zuccarello M, et al. Cocaine-induced endothelin-1-dependent spasm in rabbit basilar artery in vivo. J Cardiovasc Pharmacol 2003 Feb; 41 (2): 158–61.PubMedCrossRefGoogle Scholar
  42. 42.
    Wilbert-Lampen U, Seliger C, Zilker T, et al. Cocaine increases the endothelial release of immunoreactive endothelin and its concentrations in human plasma and urine: reversal by coincubation with sigma-receptor antagonists. Circulation 1998 Aug 4; 98 (5): 385–90.PubMedCrossRefGoogle Scholar
  43. 43.
    Dhawan SS, Wang BW. Four-extremity gangrene associated with crack cocaine abuse. Ann Emerg Med 2007 Feb; 49 (2): 186–9.PubMedCrossRefGoogle Scholar
  44. 44.
    Pradhan L, Dabisch PA, Liles JT, et al. Effect of acute intravenous cocaine administration on endothelium-dependent vasodepressor responses to acetylcholine. J Cardiovasc Pharmacol Ther 2003 Mar; 8 (1): 43–51.PubMedCrossRefGoogle Scholar
  45. 45.
    He J, Yang S, Zhang L. Effects of cocaine on nitric oxide production in bovine coronary artery endothelial cells. J Pharmacol Exp Ther 2005 Sep; 314 (3): 980–6.PubMedCrossRefGoogle Scholar
  46. 46.
    Togna GI, Graziani M, Russo P, et al. Cocaine toxic effect on endothelium-dependent vasorelaxation: an in vitro study on rabbit aorta. Toxicol Lett 2001 Aug 6; 123 (1): 43–50.PubMedCrossRefGoogle Scholar
  47. 47.
    Amin M, Gabelman G, Karpel J, et al. Acute myocardial infarction and chest pain syndromes after cocaine use. Am J Cardiol 1990 Dec 15; 66 (20): 1434–7.PubMedCrossRefGoogle Scholar
  48. 48.
    Dressler FA, Malekzadeh S, Roberts WC. Quantitative analysis of amounts of coronary arterial narrowing in cocaine addicts. Am J Cardiol 1990 Feb 1; 65 (5): 303–8.PubMedCrossRefGoogle Scholar
  49. 49.
    Boehrer JD, Moliterno DJ, Willard JE, et al. Hemodynamic effects of intranasal cocaine in humans. J Am Coll Cardiol 1992 Jul; 20 (1): 90–3.PubMedCrossRefGoogle Scholar
  50. 50.
    Kolodgie FD, Virmani R, Cornhill JF, et al. Increase in atherosclerosis and adventitial mast cells in cocaine abusers: an alternative mechanism of cocaine-associated coronary vasospasm and thrombosis. J Am Coll Cardiol 1991 Jun; 17 (7): 1553–60.PubMedCrossRefGoogle Scholar
  51. 51.
    Atkinson JB, Harlan CW, Harlan GC, et al. The association of mast cells and atherosclerosis: a morphologic study of early atherosclerotic lesions in young people. Hum Pathol 1994 Feb; 25 (2): 154–9.PubMedCrossRefGoogle Scholar
  52. 52.
    Lau DC, Dhillon B, Yan H, et al. Adipokines: molecular links between obesity and atherosclerosis. Am J Physiol Heart Circ Physiol 2005 May; 288 (5): H2031–41.PubMedCrossRefGoogle Scholar
  53. 53.
    Ridker PM. Clinical application of C-reactive protein for cardiovascular disease detection and prevention. Circulation 2003 Jan 28; 107 (3): 363–9.PubMedCrossRefGoogle Scholar
  54. 54.
    Pasceri V, Willerson JT, Yeh ET. Direct proinflammatory effect of C-reactive protein on human endothelial cells. Circulation 2000 Oct 31; 102 (18): 2165–8.PubMedCrossRefGoogle Scholar
  55. 55.
    Verma S, Li SH, Badiwala MV, et al. Endothelin antagonism and interleukin-6 inhibition attenuate the proatherogenic effects of C-reactive protein. Circulation 2002 Apr 23; 105 (16): 1890–6.PubMedCrossRefGoogle Scholar
  56. 56.
    Siegel AJ, Mendelson JH, Sholar MB, et al. Effect of cocaine usage on C-reactive protein, von Willebrand factor, and fibrinogen. Am J Cardiol 2002 May 1; 89 (9): 1133–5.PubMedCrossRefGoogle Scholar
  57. 57.
    Meng Q, Lima JA, Lai H, et al. Elevated C-reactive protein levels are associated with endothelial dysfunction in chronic cocaine users. Int J Cardiol 2003 Apr; 88 (2–3): 191–8.PubMedCrossRefGoogle Scholar
  58. 58.
    Khera A, McGuire DK, Murphy SA, et al. Race and gender differences in C-reactive protein levels. J Am Coll Cardiol 2005 Aug 2; 46 (3): 464–9.PubMedCrossRefGoogle Scholar
  59. 59.
    Albert MA, Glynn RJ, Buring J, et al. C-reactive protein levels among women of various ethnic groups living in the United States (from the Women’s Health Study). Am J Cardiol 2004 May 15; 93 (10): 1238–42.PubMedCrossRefGoogle Scholar
  60. 60.
    Lloyd-Jones DM, Liu K, Tian L, et al. Narrative review: assessment of C-reactive protein in risk prediction for cardiovascular disease. Ann Intern Med 2006 Jun 5; (145): 21–29.Google Scholar
  61. 61.
    Kugelmass AD, Oda A, Monahan K, et al. Activation of human platelets by cocaine. Circulation 1993 Sep; 88 (3): 876–83.PubMedCrossRefGoogle Scholar
  62. 62.
    Harrison P, Cramer EM. Platelet alpha-granules. Blood Rev 1993 Mar; 7 (1): 52–62.PubMedCrossRefGoogle Scholar
  63. 63.
    Heesch CM, Wilhelm CR, Ristich J, et al. Cocaine activates platelets and increases the formation of circulating platelet containing microaggregates in humans. Heart 2000 Jun; 83 (6): 688–95.PubMedCrossRefGoogle Scholar
  64. 64.
    Ruggeri ZM. Von Willebrand factor. J Clin Invest 1997 Feb 15; 99 (4): 559–64.PubMedCrossRefGoogle Scholar
  65. 65.
    Siegel AJ, Sholar MB, Mendelson JH, et al. Cocaine-induced erythrocytosis and increase in von Willebrand factor: evidence for drug-related blood doping and prothrombotic effects. Arch Intern Med 1999 Sep 13; 159 (16): 1925–9.PubMedCrossRefGoogle Scholar
  66. 66.
    Moliterno DJ, Lange RA, Gerard RD, et al. Influence of intranasal cocaine on plasma constituents associated with endogenous thrombosis and thrombolysis. Am J Med 1994 Jun; 96 (6): 492–6.PubMedCrossRefGoogle Scholar
  67. 67.
    Egred M, Davis GK. Cocaine and the heart. Postgrad Med J 2005 Sep; 81 (959): 568–71.PubMedCrossRefGoogle Scholar
  68. 68.
    Hollander JE, Levitt MA, Young GP, et al. Effect of recent cocaine use on the specificity of cardiac markers for diagnosis of acute myocardial infarction. Am Heart J 1998 Feb; 135 (2 Pt 1): 245–52.PubMedCrossRefGoogle Scholar
  69. 69.
    Brody SL, Slovis CM, Wrenn KD. Cocaine-related medical problems: consecutive series of 233 patients. Am J Med 1990 Apr; 88 (4): 325–31.PubMedCrossRefGoogle Scholar
  70. 70.
    Hollander JE, Hoffman RS, Gennis P, et al. Prospective multicenter evaluation of cocaine-associated chest pain. Cocaine Associated Chest Pain (COCHPA) Study Group. Acad Emerg Med 1994 Jul–Aug; 1 (4): 330–9.PubMedCrossRefGoogle Scholar
  71. 71.
    Weber JE, Shofer FS, Larkin GL, et al. Validation of a brief observation period for patients with cocaine-associated chest pain. N Engl J Med 2003 Feb 6; 348 (6): 510–7.PubMedCrossRefGoogle Scholar
  72. 72.
    Sharma AK, Hamwi SM, Garg N, et al. Percutaneous interventions in patients with cocaine-associated myocardial infarction: a case series and review. Catheter Cardiovasc Interv 2002 Jul; 56 (3): 346–52.PubMedCrossRefGoogle Scholar
  73. 73.
    Lange RA. Cocaine and myocardial infarction. Johns Hopkins Advanced Studies in Medicine 2003; 3 (8): 448–55.Google Scholar
  74. 74.
    Lange RA, Hillis LD. Cardiovascular complications of cocaine use. N Engl J Med 2001 Aug 2; 345 (5): 351–8.PubMedCrossRefGoogle Scholar
  75. 75.
    Lange RA, Cigarroa RG, Flores ED, et al. Potentiation of cocaine-induced coronary vasoconstriction by beta-adrenergic blockade. Ann Intern Med 1990 Jun 15; 112(12): 897–903.PubMedGoogle Scholar
  76. 76.
    Hoffman RS. Cocaine and beta-blockers: should the controversy continue? Ann Emerg Med 2008 Feb; 51 (2): 127–9.PubMedCrossRefGoogle Scholar
  77. 77.
    Boehrer JD, Moliterno DJ, Willard JE, et al. Influence of labetalol on cocaine-induced coronary vasoconstriction in humans. Am J Med 1993 Jun; 94 (6): 608–10.PubMedCrossRefGoogle Scholar
  78. 78.
    Cubeddu LX, Fuenmayor N, Varin F, et al. Mechanism of the vasodilatory effect of carvedilol in normal volunteers: a comparison with labetalol. J Cardiovasc Pharmacol 1987; 10 Suppl. 11: S81–4.PubMedGoogle Scholar
  79. 79.
    Page 2nd RL, Utz KJ, Wolfel EE. Should beta-blockers be used in the treatment of cocaine-associated acute coronary syndrome? Ann Pharmac-other 2007 Dec; 41 (12): 2008–13.CrossRefGoogle Scholar
  80. 80.
    Sofuoglu M, Brown S, Babb DA, et al. Carvedilol affects the physiological and behavioral response to smoked cocaine in humans. Drug Alcohol Depend 2000 Jul 1; 60 (1): 69–76.PubMedGoogle Scholar
  81. 81.
    Fonarow GC, Lukas MA, Robertson M, et al. Effects of carvedilol early after myocardial infarction: analysis of the first 30 days in Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction (CAPRICORN). Am Heart J 2007 Oct; 154 (4): 637–44.PubMedCrossRefGoogle Scholar
  82. 82.
    Dattilo PB, Hailpern SM, Fearon K, et al. Beta-blockers are associated with reduced risk of myocardial infarction after cocaine use. Ann Emerg Med 2008 Feb; 51 (2): 117–25.PubMedCrossRefGoogle Scholar
  83. 83.
    Bauman JL, Grawe JJ, Winecoff AP, et al. Cocaine-related sudden cardiac death: a hypothesis correlating basic science and clinical observations. J Clin Pharmacol 1994 Sep; 34 (9): 902–11.PubMedGoogle Scholar
  84. 84.
    Billman GE. Effect of calcium channel antagonists on cocaine-induced malignant arrhythmias: protection against ventricular fibrillation. J Pharmacol Exp Ther 1993 Jul; 266 (1): 407–16.PubMedGoogle Scholar
  85. 85.
    Keating MT, Sanguinetti MC. Molecular and cellular mechanisms of cardiac arrhythmias. Cell 2001 Feb 23; 104 (4): 569–80.PubMedCrossRefGoogle Scholar
  86. 86.
    Marban E. Cardiac channelopathies. Nature 2002 Jan 10; 415 (6868): 213–8.PubMedCrossRefGoogle Scholar
  87. 87.
    Premkumar LS. Selective potentiation of L-type calcium channel currents by cocaine in cardiac myocytes. Mol Pharmacol 1999 Dec; 56 (6): 1138–42.PubMedGoogle Scholar
  88. 88.
    Antzelevitch C, Brugada P, Borggrefe M, et al. Brugada syndrome: report of the second consensus conference — endorsed by the Heart Rhythm Society and the European Heart Rhythm Association. Circulation 2005 Feb 8; 111 (5): 659–70.PubMedCrossRefGoogle Scholar
  89. 89.
    Weiner RB, Weiner SD, Yurchak PM. Removing the mask. Am J Med 2008 Feb; 121(2): 113–6.PubMedCrossRefGoogle Scholar
  90. 90.
    Bebarta VS, Summers S. Brugada electrocardiographic pattern induced by cocaine toxicity. Ann Emerg Med 2007 Jun; 49 (6): 827–9.PubMedCrossRefGoogle Scholar
  91. 91.
    Grigorov V, Goldberg L, Foccard JP. Cardiovascular complications of acute cocaine poisoning: a clinical case report. Cardiovasc J S Afr 2004 May–Jun; 15(3): 139–42.PubMedGoogle Scholar
  92. 92.
    Ortega-Carnicer J, Bertos-Polo J, Gutierrez-Tirado C. Aborted sudden death, transient Brugada pattern, and wide QRS dysrhythmias after massive cocaine ingestion. J Electrocardiol 2001 Oct; 34 (4): 345–9.PubMedCrossRefGoogle Scholar
  93. 93.
    Littmann L, Monroe MH, Svenson RH. Brugada-type electrocardiographic pattern induced by cocaine. Mayo Clin Proc 2000 Aug; 75 (8): 845–9.PubMedCrossRefGoogle Scholar
  94. 94.
    Junttila MJ, Gonzalez M, Lizotte E, et al. Induced Brugada-type electrocardiogram, a sign for imminent malignant arrhythmias. Circulation 2008 Apr 8; 117(14): 1890–3.PubMedCrossRefGoogle Scholar
  95. 95.
    Gitter MJ, Goldsmith SR, Dunbar DN, et al. Cocaine and chest pain: clinical features and outcome of patients hospitalized to rule out myocardial infarction. Ann Intern Med 1991 Aug 15; 115 (4): 277–82.PubMedGoogle Scholar
  96. 96.
    O’Leary ME. Inhibition of human ether-a-go-go potassium channels by cocaine. Mol Pharmacol 2001 Feb; 59 (2): 269–77.PubMedGoogle Scholar
  97. 97.
    Tseng GN. I(Kr): the hERG channel. J Mol Cell Cardiol 2001 May; 33 (5): 835–49.PubMedCrossRefGoogle Scholar
  98. 98.
    Magnano AR, Talathoti NB, Hallur R, et al. Effect of acute cocaine administration on the QTc interval of habitual users. Am J Cardiol 2006 Apr 15; 97 (8): 1244–6.PubMedCrossRefGoogle Scholar
  99. 99.
    Grohe C, Meyer R. The cardiac cocaine connection. Cardiovasc Res 2003 Oct 1; 59 (4): 805–6.PubMedCrossRefGoogle Scholar
  100. 100.
    Haigney MC, Alam S, Tebo S, et al. Intravenous cocaine and QT variability. J Cardiovasc Electrophysiol 2006 Jun; 17 (6): 610–6.PubMedCrossRefGoogle Scholar
  101. 101.
    Haigney MC, Zareba W, Gentlesk PJ, et al. QT interval variability and spontaneous ventricular tachycardia or fibrillation in the Multicenter Automatic Defibrillator Implantation Trial (MADIT) II patients. J Am Coll Cardiol 2004 Oct 6; 44 (7): 1481–7.PubMedCrossRefGoogle Scholar
  102. 102.
    Kuczkowski KM. More on the idiosyncratic effects of cocaine on the human heart. Emerg Med J 2007 Feb; 24 (2): 147.PubMedCrossRefGoogle Scholar
  103. 103.
    Blomstrom-Lundqvist C, Scheinman MM, Aliot EM, et al. ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias-executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Supraventricular Arrhythmias). Circulation 2003 Oct 14; 108 (15): 1871–909.PubMedCrossRefGoogle Scholar
  104. 104.
    Fuster V, O’Rourke R, Walsh R, et al., editors. Hurst’s the heart. 12th ed. New York (NY): McGraw-Hill Medical, 2008.Google Scholar
  105. 105.
    Hahn IH, Hoffman RS. Cocaine use and acute myocardial infarction. Emerg Med Clin North Am 2001 May; 19 (2): 493–510.PubMedCrossRefGoogle Scholar
  106. 106.
    Kerns 2nd W, Garvey L, Owens J. Cocaine-induced wide complex dysrhythmia. J Emerg Med 1997 May–Jun; 15 (3): 321–9.PubMedCrossRefGoogle Scholar
  107. 107.
    Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 8: advanced challenges in resuscitation; section 2, toxicology in ECC. The American Heart Association in collaboration with the International Liaison Committee on Resuscitation. Circulation 2000 Aug 22; 102 (8 Suppl.): I223–8.Google Scholar
  108. 108.
    Shih RD, Hollander JE, Burstein JL, et al. Clinical safety of lidocaine in patients with cocaine-associated myocardial infarction. Ann Emerg Med 1995 Dec; 26 (6): 702–6.PubMedCrossRefGoogle Scholar
  109. 109.
    Dewitt CR, Cleveland N, Dart RC, et al. The effect of amiodarone pretreatment on survival of mice with cocaine toxicity. J Med Toxicol 2005 Dec; 1(1): 11–8.PubMedCrossRefGoogle Scholar
  110. 110.
    Jessup M, Brozena S. Heart failure. N Engl J Med 2003 May 15; 348 (20): 2007–18.PubMedCrossRefGoogle Scholar
  111. 111.
    Crawford M, DiMarco J, Paulus W, et al. Cardiology. 2nd ed. Philadelphia (PA): Mosby, 2003.Google Scholar
  112. 112.
    Francis GS. Pathophysiology of chronic heart failure. Am J Med 2001 May 7; 110 (7 Suppl.): 37S–46S.PubMedCrossRefGoogle Scholar
  113. 113.
    Mann DL, Bristow MR. Mechanisms and models in heart failure: the biomechanical model and beyond. Circulation 2005 May 31; 111 (21): 2837–49.PubMedCrossRefGoogle Scholar
  114. 114.
    Iacobellis G, Kemp W. Cardiomyocyte apoptosis in cocaine-induced myocarditis with involvement of bundle of His and left bundle branch. Int J Cardiol 2006 Sep 10; 112 (1): 116–8.PubMedCrossRefGoogle Scholar
  115. 115.
    Lakoski JM, Rittenhouse PA, Bonadonna AM, et al. Acute, but not repeated, cocaine administration decreases renin secretion in the conscious male rat. Neurosci Lett 1991 Jun 24; 127 (2): 181–4.PubMedCrossRefGoogle Scholar
  116. 116.
    Levy AD, Li Q, Alvarez Sanz MC, et al. Neuroendocrine responses to cocaine do not exhibit sensitization following repeated cocaine exposure. Life Sci 1992; 51 (12): 887–97.PubMedCrossRefGoogle Scholar
  117. 117.
    Levy AD, Rittenhouse PA, Bonadonna AM, et al. Repeated exposure to cocaine produces long-lasting deficits in the serotonergic stimulation of prolactin and renin, but not adrenocorticotropin secretion. Eur J Pharmacol 1993 Sep 14; 241 (2–3): 275–8.PubMedCrossRefGoogle Scholar
  118. 118.
    Levy AD, Rittenhouse PA, Li Q, et al. Cocaine-induced suppression of renin secretion is partially mediated by serotonergic mechanisms. Pharmacol Biochem Behav 1992 Jul; 42 (3): 481–6.PubMedCrossRefGoogle Scholar
  119. 119.
    Hargrave B, Lattanzio F. Cocaine activates the renin-angiotensin system in pregnant rabbits and alters the response to ischemia. Cardiovasc Toxicol 2002; 2 (2): 91–7.PubMedCrossRefGoogle Scholar
  120. 120.
    Brecklin CS, Bauman JL. Cardiovascular effects of cocaine: focus on hypertension. J Clin Hypertens 1999 Nov; 1 (3): 212–7.Google Scholar
  121. 121.
    Brecklin CS, Gopaniuk-Folga A, Kravetz T, et al. Prevalence of hypertension in chronic cocaine users. Am J Hypertens 1998 Nov; 11 (11 Pt 1): 1279–83.PubMedCrossRefGoogle Scholar
  122. 122.
    Waspe LE, Ordahl CP, Simpson PC. The cardiac beta-myosin heavy chain isogene is induced selectively in alpha l-adrenergic receptor-stimulated hypertrophy of cultured rat heart myocytes. J Clin Invest 1990 Apr; 85 (4): 1206–14.PubMedCrossRefGoogle Scholar
  123. 123.
    Henning RJ, Silva J, Reddy V, et al. Cocaine increases beta-myosin heavychain protein expression in cardiac myocytes. J Cardiovasc Pharmacol Ther 2000 Oct; 5 (4): 313–22.PubMedCrossRefGoogle Scholar
  124. 124.
    Kariya K, Karns LR, Simpson PC. An enhancer core element mediates stimulation of the rat beta-myosin heavy chain promoter by an alpha l-adrenergic agonist and activated beta-protein kinase C in hypertrophy of cardiac myocytes. J Biol Chem 1994 Feb 4; 269 (5): 3775–82.PubMedGoogle Scholar
  125. 125.
    Henning RJ, Li Y. Cocaine produces cardiac hypertrophy by protein kinase C dependent mechanisms. J Cardiovasc Pharmacol Ther 2003 Jun; 8 (2): 149–60.PubMedCrossRefGoogle Scholar
  126. 126.
    Amin JK, Xiao L, Pimental DR, et al. Reactive oxygen species mediate alpha-adrenergic receptor-stimulated hypertrophy in adult rat ventricular myocytes. J Mol Cell Cardiol 2001 Jan; 33 (1): 131–9.PubMedCrossRefGoogle Scholar
  127. 127.
    Isabelle M, Monteil C, Moritz F, et al. Role of alpha l-adrenoreceptors in cocaine-induced NADPH oxidase expression and cardiac dysfunction. Cardiovasc Res 2005 Sep 1; 67 (4): 699–704.PubMedCrossRefGoogle Scholar
  128. 128.
    Hund TJ, Rudy Y. A role for calcium/calmodulin-dependent protein kinase II in cardiac disease and arrhythmia. Handb Exp Pharmacol 2006; 171: 201–20.PubMedCrossRefGoogle Scholar
  129. 129.
    Henning RJ, Cuevas J. Cocaine activates calcium/calmodulin kinase II and causes cardiomyocyte hypertrophy. J Cardiovasc Pharmacol 2006 Jul; 48 (1): 802–13.PubMedCrossRefGoogle Scholar
  130. 130.
    Gustafsson AB, Gottlieb RA. Mechanisms of apoptosis in the heart. J Clin Immunol 2003 Nov; 23 (6): 447–59.PubMedCrossRefGoogle Scholar
  131. 131.
    Li G, Xiao Y, Zhang L. Cocaine induces apoptosis in fetal rat myocardial cells through the p38 mitogen-activated protein kinase and mitochondrial/cytochrome c pathways. J Pharmacol Exp Ther 2005 Jan; 312 (1): 112–9.PubMedCrossRefGoogle Scholar
  132. 132.
    Haq S, Choukroun G, Lim H, et al. Differential activation of signal transduction pathways in human hearts with hypertrophy versus advanced heart failure. Circulation 2001 Feb 6; 103 (5): 670–7.PubMedCrossRefGoogle Scholar
  133. 133.
    Zhang L, Xiao Y, He J. Cocaine and apoptosis in myocardial cells. Anat Rec 1999 Dec 15; 257 (6): 208–16.PubMedCrossRefGoogle Scholar
  134. 134.
    Reed JC, Paternostro G. Postmitochondrial regulation of apoptosis during heart failure. Proc Natl Acad Sci U S A 1999 Jul 6; 96 (14): 7614–6.PubMedCrossRefGoogle Scholar
  135. 135.
    Virmani R, Robinowitz M, Smialek JE, et al. Cardiovascular effects of cocaine: an autopsy study of 40 patients. Am Heart J 1988 May; 115 (5): 1068–76.PubMedCrossRefGoogle Scholar
  136. 136.
    Feldman AM, McNamara D. Myocarditis. N Engl J Med 2000 Nov 9; 343(19): 1388–98.CrossRefGoogle Scholar
  137. 137.
    FreireCastroseiros E, PenasLado M, CastroBeiras A. Pathology of the heart of noncardiac origin: VIII, cocaine and the heart. Rev Esp Cardiol 1998 May; 51 (5): 396–401.Google Scholar
  138. 138.
    Kawai C. From myocarditis to cardiomyopathy: mechanisms of inflammation and cell death — learning from the past for the future. Circulation 1999 Mar 2; 99 (8): 1091–100.PubMedCrossRefGoogle Scholar
  139. 139.
    Wiener RS, Lockhart JT, Schwartz RG. Dilated cardiomyopathy and cocaine abuse: report of two cases. Am J Med 1986 Oct; 81 (4): 699–701.PubMedCrossRefGoogle Scholar
  140. 140.
    Sorescu D, Griendling KK. Reactive oxygen species, mitochondria, and NAD(P)H oxidases in the development and progression of heart failure. Congest Heart Fail 2002 May–Jun; 8 (3): 132–40.PubMedCrossRefGoogle Scholar
  141. 141.
    Byrne JA, Grieve DJ, Cave AC, et al. Oxidative stress and heart failure. Arch Mal Coeur Vaiss 2003 Mar; 96 (3): 214–21.PubMedGoogle Scholar
  142. 142.
    Moritz F, Monteil C, Isabelle M, et al. Role of reactive oxygen species in cocaine-induced cardiac dysfunction. Cardiovasc Res 2003 Oct 1; 59 (4): 834–43.PubMedCrossRefGoogle Scholar
  143. 143.
    Isabelle M, Vergeade A, Moritz F, et al. NADPH oxidase inhibition prevents cocaine-induced up-regulation of xanthine oxidoreductase and cardiac dysfunction. J Mol Cell Cardiol 2007 Feb; 42 (2): 326–32.PubMedCrossRefGoogle Scholar
  144. 144.
    Wei CM, Lerman A, Rodeheffer RJ, et al. Endothelin in human congestive heart failure. Circulation 1994 Apr; 89 (4): 1580–6.PubMedCrossRefGoogle Scholar
  145. 145.
    Hogya PT, Wolfson AB. Chronic cocaine abuse associated with dilated cardiomyopathy. Am J Emerg Med 1990 May; 8 (3): 203–4.PubMedCrossRefGoogle Scholar
  146. 146.
    Henzlova MJ, Smith SH, Prchal VM, et al. Apparent reversibility of cocaine-induced congestive cardiomyopathy. Am Heart J 1991 Aug; 122(2): 577–9.PubMedCrossRefGoogle Scholar
  147. 147.
    Om A, Ellahham S, Ornato JP. Reversibility of cocaine-induced cardiomyopathy. Am Heart J 1992 Dec; 124 (6): 1639–41.PubMedCrossRefGoogle Scholar
  148. 148.
    Chokshi SK, Moore R, Pandian NG, et al. Reversible cardiomyopathy associated with cocaine intoxication. Ann Intern Med 1989 Dec 15; 111 (12): 1039–40.PubMedGoogle Scholar
  149. 149.
    Hollander JE, Hoffman RS, Gennis P, et al. Cocaine-associated chest pain: one-year follow-up. Acad Emerg Med 1995 Mar; 2 (3): 179–84.PubMedCrossRefGoogle Scholar
  150. 150.
    Dackis CA, O’Brien CP. Cocaine dependence: a disease of the brain’s reward centers. J Subst Abuse Treat 2001 Oct; 21 (3): 111–7.PubMedCrossRefGoogle Scholar
  151. 151.
    Gardner TJ, Kosten TR. Therapeutic options and challenges for substances of abuse. Dialogues Clin Neurosci 2007; 9 (4): 431–45.PubMedGoogle Scholar
  152. 152.
    Karila L, Gorelick D, Weinstein A, et al. New treatments for cocaine dependence: a focused review. Int J Neuropsychopharmacol 2008 May; 11 (3): 425–38.PubMedCrossRefGoogle Scholar
  153. 153.
    Martell BA, Mitchell E, Poling J, et al. Vaccine pharmacotherapy for the treatment of cocaine dependence. Biol Psychiatry 2005 Jul 15; 58 (2): 158–64.PubMedCrossRefGoogle Scholar
  154. 154.
    Lathers CM, Tyau LS, Spino MM, et al. Cocaine-induced seizures, arrhythmias and sudden death. J Clin Pharmacol 1988 Jul; 28 (7): 584–93.PubMedGoogle Scholar
  155. 155.
    Zheng ZJ, Croft JB, Giles WH, et al. Sudden cardiac death in the United States, 1989 to 1998. Circulation 2001 Oct 30; 104 (18): 2158–63.PubMedCrossRefGoogle Scholar
  156. 156.
    Schifano F, Corkery J. Cocaine/crack cocaine consumption, treatment demand, seizures, related offences, prices, average purity levels and deaths in the UK (1990–2004). J Psychopharmacol 2008 Jan; 22 (1): 71–9.PubMedCrossRefGoogle Scholar
  157. 157.
    Fineschi V, Centini F, Monciotti F, et al. The cocaine “body stuffer” syndrome: a fatal case. Forensic Sci Int 2002 Mar 28; 126 (1): 7–10.PubMedCrossRefGoogle Scholar
  158. 158.
    Koehler SA, Ladham S, Rozin L, et al. The risk of body packing: a case of a fatal cocaine overdose. Forensic Sci Int 2005 Jun 30; 151 (1): 81–4.PubMedCrossRefGoogle Scholar
  159. 159.
    De Prost N, Lefebvre A, Questel F, et al. Prognosis of cocaine body-packers. Intensive Care Med 2005 Jul; 31 (7): 955–8.PubMedCrossRefGoogle Scholar
  160. 160.
    Sporer KA, Firestone J. Clinical course of crack cocaine body stuffers. Ann Emerg Med 1997 May; 29 (5): 596–601.PubMedCrossRefGoogle Scholar
  161. 161.
    McCance-Katz EF, Kosten TR, Jatlow P. Concurrent use of cocaine and alcohol is more potent and potentially more toxic than use of either alone: a multiple-dose study. Biol Psychiatry 1998 Aug 15; 44 (4): 250–9.PubMedCrossRefGoogle Scholar
  162. 162.
    Randall T. Cocaine, alcohol mix in body to form even longer lasting, more lethal drug. JAMA 1992 Feb 26; 267 (8): 1043–4.PubMedCrossRefGoogle Scholar
  163. 163.
    McCance-Katz EF, Price LH, McDougle CJ, et al. Concurrent cocaineethanol ingestion in humans: pharmacology, physiology, behavior, and the role of cocaethylene. Psychopharmacology (Berl) 1993; 111 (1): 39–46.CrossRefGoogle Scholar
  164. 164.
    Grant BF, Harford TC. Concurrent and simultaneous use of alcohol with cocaine: results of national survey. Drug Alcohol Depend 1990 Feb; 25 (1): 97–104.PubMedCrossRefGoogle Scholar
  165. 165.
    Brookoff D, Rotondo MF, Shaw LM, et al. Cocaethylene levels in patients who test positive for cocaine. Ann Emerg Med 1996 Mar; 27 (3): 316–20.PubMedCrossRefGoogle Scholar
  166. 166.
    Rounsaville BJ, Anton SF, Carroll K, et al. Psychiatric diagnoses of treatment-seeking cocaine abusers. Arch Gen Psychiatry 1991 Jan; 48 (1): 43–51.PubMedCrossRefGoogle Scholar
  167. 167.
    Farre M, de la Torre R, Llorente M, et al. Alcohol and cocaine interactions in humans. J Pharmacol Exp Ther 1993 Sep; 266 (3): 1364–73.PubMedGoogle Scholar
  168. 168.
    Farre M, de la Torre R, Gonzalez ML, et al. Cocaine and alcohol interactions in humans: neuroendocrine effects and cocaethylene metabolism. J Pharmacol Exp Ther 1997 Oct; 283 (1): 164–76.PubMedGoogle Scholar
  169. 169.
    Perez-Reyes M, Jeffcoat AR. Ethanol/cocaine interaction: cocaine and cocaethylene plasma concentrations and their relationship to subjective and cardiovascular effects. Life Sci 1992; 51 (8): 553–63.PubMedCrossRefGoogle Scholar
  170. 170.
    Perez-Reyes M. The order of drug administration: its effects on the interaction between cocaine and ethanol. Life Sci 1994; 55 (7): 541–50.PubMedCrossRefGoogle Scholar
  171. 171.
    Harris DS, Everhart ET, Mendelson J, et al. The pharmacology of cocaethylene in humans following cocaine and ethanol administration. Drug Alcohol Depend 2003 Nov 24; 72 (2): 169–82.PubMedCrossRefGoogle Scholar
  172. 172.
    Perez-Reyes M. Subjective and cardiovascular effects of cocaethylene in humans. Psychopharmacology (Berl) 1993; 113 (1): 144–7.CrossRefGoogle Scholar
  173. 173.
    Fuster V, Alexander R, O’Rourke R, editors. Hurst’s the heart. 10th ed. New York, London: McGraw-Hill, 2001.Google Scholar
  174. 174.
    Hammond AS, Bailey PL. Acute spontaneous coronary artery dissection in the peripartum period. J Cardiothorac Vasc Anesth 2006 Dec; 20 (6): 837–41.PubMedCrossRefGoogle Scholar
  175. 175.
    Almeda FQ, Barkatullah S, Kavinsky CJ. Spontaneous coronary artery dissection. Clin Cardiol 2004 Jul; 27 (7): 377–80.PubMedCrossRefGoogle Scholar
  176. 176.
    Eagle KA, Isselbacher EM, DeSanctis RW. Cocaine-related aortic dissection in perspective. Circulation 2002 Apr 2; 105 (13): 1529–30.PubMedGoogle Scholar
  177. 177.
    Pretre R, Von Segesser LK. Aortic dissection. Lancet 1997 May 17; 349 (9063): 1461–4.PubMedCrossRefGoogle Scholar
  178. 178.
    Palmiere C, Burkhardt S, Staub C, et al. Thoracic aortic dissection associated with cocaine abuse. Forensic Sci Int 2004 May 10; 141 (2–3): 137–42.PubMedCrossRefGoogle Scholar
  179. 179.
    Hsue PY, Salinas CL, Bolger AF, et al. Acute aortic dissection related to crack cocaine. Circulation 2002 Apr 2; 105 (13): 1592–5.PubMedCrossRefGoogle Scholar
  180. 180.
    Steinhauer JR, Caulfield JB. Spontaneous coronary artery dissection associated with cocaine use: a case report and brief review. Cardiovasc Pathol 2001 May–Jun; 10 (3): 141–5.PubMedCrossRefGoogle Scholar
  181. 181.
    Kamineni R, Sadhu A, Alpert JS. Spontaneous coronary artery dissection: report of two cases and a 50-year review of the literature. Cardiol Rev 2002 Sep–Oct; 10 (5): 279–84.PubMedCrossRefGoogle Scholar
  182. 182.
    Arshad A, Mandava A, Kamath G, et al. Sudden cardiac death and the role of medical therapy. Prog Cardiovasc Dis 2008 May–Jun; 50 (6): 420–38.PubMedCrossRefGoogle Scholar
  183. 183.
    Om A, Ellahham S, DiSciascio G. Management of cocaine-induced cardiovascular complications. Am Heart J 1993 Feb; 125 (2 Pt 1): 469–75.PubMedCrossRefGoogle Scholar
  184. 184.
    Derlet RW, Albertson TE, Tharratt RS. Lidocaine potentiation of cocaine toxicity. Ann Emerg Med 1991 Feb; 20 (2): 135–8.PubMedCrossRefGoogle Scholar
  185. 185.
    Anderson JL, Rodier HE, Green LS. Comparative effects of beta-adrenergic blocking drugs on experimental ventricular fibrillation threshold. Am J Cardiol 1983 Apr; 51 (7): 1196–202.PubMedCrossRefGoogle Scholar
  186. 186.
    Rashid J, Eisenberg MJ, Topol EJ. Cocaine-induced aortic dissection. Am Heart J 1996 Dec; 132(6): 1301–4.PubMedCrossRefGoogle Scholar
  187. 187.
    Fuller ET, Milling Jr TJ, Price B, et al. Therapeutic hypothermia in cocaineinduced cardiac arrest. Ann Emerg Med 2008 Feb; 51 (2): 135–7.PubMedCrossRefGoogle Scholar
  188. 188.
    Hauer RN, Aliot E, Block M, et al. Indications for implantable cardioverter defibrillator (ICD) therapy. Study Group on Guidelines on ICDs of the Working Group on Arrhythmias and the Working Group on Cardiac Pacing of the European Society of Cardiology. Eur Heart J 2001 Jul; 22 (13): 1074–81.PubMedCrossRefGoogle Scholar
  189. 189.
    Chen J, Naseem RH, Obel O, et al. Habitual cocaine use is associated with high defibrillation threshold during ICD implantation. J Cardiovasc Electrophysiol 2007 Jul; 18 (7): 722–5.PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2009

Authors and Affiliations

  • Katharine Phillips
    • 1
  • Adriana Luk
    • 2
  • Gursharan S. Soor
    • 1
  • Jonathan R. Abraham
    • 1
  • Shaun Leong
    • 1
  • Jagdish Butany
    • 1
    • 3
    Email author
  1. 1.Department of Pathology 11E-420Toronto General Hospital/University Health NetworkTorontoCanada
  2. 2.Department of MedicineToronto General Hospital/University Health NetworkTorontoCanada
  3. 3.Departments of Laboratory Medicine and Pathobiology, Faculty of MedicineUniversity of TorontoTorontoCanada

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