Reversible Cardiomyopathy Associated with Cocaine Intoxication

Excerpt Cocaine intoxication typically produces a profoundly enhanced sympathomimetic state and has been temporally associated with various serious, including fatal, medical disorders.

Abstract

Brief Reports15 December 1989Reversible Cardiomyopathy Associated with Cocaine IntoxicationSaurabh K. Chokshi, MD, Richard Moore, MD, Natesa G. Pandian, MD, Jeffrey M. Isner, MDSaurabh K. Chokshi, MD, Richard Moore, MD, Natesa G. Pandian, MD, Jeffrey M. Isner, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-12-1039 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptCocaine intoxication typically produces a profoundly enhanced sympathomimetic state and has been temporally associated with various serious, including fatal, medical disorders. Chief among these disorders are cardiovascular complications, principally acute myocardial infarction (1). Dilated cardiomyopathy has been reported only rarely in association with cocaine abuse (2, 3). We describe a patient who developed an acutely dilated cardiomyopathy temporally related to smoking ("free-basing") the "crack" formulation of cocaine. Over 2 weeks, however, serial noninvasive studies showed reversal of her cardiomyopathy with a marked improvement in left ventricular systolic function. This patient's course was similar to that of patients with reversible catecholamine...References1. IsnerEstesThompson JMP. Acute cardiac events temporally related to cocaine abuse. N Engl J Med. 1986;315:1438-43. CrossrefMedlineGoogle Scholar2. WienerLockhartSchwartz RJR. Dilated cardiomyopathy and cocaine abuse: report of two cases. Am J Med. 1986;81:699-701. CrossrefMedlineGoogle Scholar3. Duell P. Chronic cocaine abuse and dilated cardiomyopathy [Letter]. Am J Med. 1987;83:601. CrossrefMedlineGoogle Scholar4. LamShubSheps JCS. Reversible dilatation of hypertrophied left ventricle in pheochromocytoma: serial two dimensional echocardiographic observations. Am Heart J. 1985;109:613-5. CrossrefMedlineGoogle Scholar5. Imperato-McGinleyGautierEhlersZulloGoldsteinVaughan JTKMDE. Reversibility of catecholamine-induced dilated cardiomyopathy in a child with a pheochromocytoma. N Engl J Med. 1987;316:793-7. CrossrefMedlineGoogle Scholar6. ScullyMarkMcNeelyMcNeely REWB. Case records of the Massachusetts General Hospital. Case 15-1988. A 26-year-old woman with cardiomyopathy, multiple strokes, and an adrenal mass. N Engl J Med. 1988;318:970-81. CrossrefMedlineGoogle Scholar7. KarchBillingham SM. Myocardial contraction bands revisited. Hum Pathol. 1986;17:9-13. CrossrefMedlineGoogle Scholar8. TazelaarKarchStephensBillingham HSBM. Cocaine and the heart. Hum Pathol. 1987;18:195-9. CrossrefMedlineGoogle Scholar9. HoffmanGoodman CP. Pulmonary edema in cocaine smokers. Radiology. 1989;172:463-5. CrossrefMedlineGoogle Scholar10. MorcosFairhurstHenry NAW. Direct but reversible effects of cocaine on the myocardium [Abstract]. J Am Coll Cardiol. 1988;11:71A. Google Scholar11. HaguePerreaultMorgan NCJ. Effects of cocaine on intracellular Ca++ handling in mammalian myocardium [Abstract]. Circulation. 1988;78:359. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: From Tufts University School of Medicine, Boston, Massachusetts. For current author addresses, see end of text. 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