Evaluation and management of the patient who has cocaine-associated chest pain.

Abstract:

:Patients who have chest pain following the use of cocaine have become more common in emergency departments throughout the United States,with approximately 6% of these patients sustaining an acute MI. The authors have described the rationale for recommending aspirin, benzodiaze-pines, and nitroglycerin as first-line treatments and calcium-channel blockade or phentolamine as possible second-line therapies and have summarized the controversies surrounding the use of fibrinolytic agents. Admission for observation is one reasonable approach to the management of the low-risk cohort. Evaluation for underlying coronary artery disease is reasonable, particularly in patients who have acute MI. Patients who do not have infarction can undergo evaluation for possible coronary artery disease on an outpatient basis. Routine interventions for secondary prophylaxis as well as cocaine rehabilitation should be used in this patient population, because the long-term prognosis seems somewhat dependent upon the ability of the patient to discontinue cocaine use.

journal_name

Cardiol Clin

journal_title

Cardiology clinics

authors

Hollander JE,Henry TD

doi

10.1016/j.ccl.2005.09.003

subject

Has Abstract

pub_date

2006-02-01 00:00:00

pages

103-14

issue

1

eissn

0733-8651

issn

1558-2264

pii

S0733-8651(05)00074-3

journal_volume

24

pub_type

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