Cardiovascular Complications of Cocaine Abuse

  • Joshua A. Perper
  • David H. Van Thiel
Part of the Recent Developments in Alcoholism book series (RDIA, volume 10)


Cardiovascular complications are among the most common and dangerous complications of cocaine abuse, ranging from episodic arrhythmias to myocardial infarction, strokes, cardiomyopathy, and sudden death. The central nervous system-mediated action of cocaine triggers an increase in circulating catecholamines, resulting in arterial vasoconstriction, increase in myocardial oxygen demand, myocardial ischemia, tachycardia, and other arrhythmias. The peripheral cardiovascular action of cocaine involves the inhibition of reuptake of catecholamines at adrenergic nerve terminals, with local release of epinephrine, direct stimulation and vasospasm of the coronary arteries, coronary intimai hyperplasia, inhibition of baroreceptors, interference with the electrical conduction through the myocardium, and direct myocardial toxicity. The cardiovascular complications of cocaine include cardiac dysrhythmias and hypertension, acute myocardial infarction, myocarditis, infectious endocarditis, ventricular dysfunction, dilated cardiomyopathy, hypotensive shock, and cerebral strokes. Cocaine-related vascular changes in the pregnant woman and fetus have been related to an increased incidence of abortion, abruptio placentae, and congenital anomalies of the fetus.


Acute Myocardial Infarction Dilate Cardiomyopathy Cardiovascular Complication Cocaine Abuse Myocardial Oxygen Demand 
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.


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Copyright information

© Springer Science+Business Media New York 1992

Authors and Affiliations

  • Joshua A. Perper
    • 1
  • David H. Van Thiel
    • 2
  1. 1.Allegheny County Coroner’s Office, Departments of Pathology and Epidemiology, School of Medicine and School of Public HealthUniversity of PittsburghPittsburghUSA
  2. 2.Department of SurgeryUniversity of Pittsburgh School of MedicinePittsburghUSA

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