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Cardiovascular Complications of Cocaine Abuse

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Recent Developments in Alcoholism

Part of the book series: Recent Developments in Alcoholism ((RDIA,volume 10))

Abstract

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.

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Authors and Affiliations

  1. Allegheny County Coroner’s Office, Departments of Pathology and Epidemiology, School of Medicine and School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, 15219, USA

    Joshua A. Perper

  2. Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, 15213, USA

    David H. Van Thiel

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  1. New York University School of Medicine, New York, New York, USA

    Marc Galanter

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Perper, J.A., Van Thiel, D.H. (1992). Cardiovascular Complications of Cocaine Abuse. In: Galanter, M. (eds) Recent Developments in Alcoholism. Recent Developments in Alcoholism, vol 10. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-1648-8_17

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