Peri-Operative MI after Intranasal Application of Cocaine for Transnasal Procedure

Abstract

Introduction: Topical cocaine is widely used by otolaryngologists during endonasal surgeries. However, its adverse cardiac effects such as tachyarrhythmias, hypertension, myocardial infarction, and cardiogenic shock limit its therapeutic use in patients with a history of cardiac disease and cardiac risk factors. Most practices suggest that the use of topical cocaine in patients without cardiac disease is relatively safe. We report a case of NSTEMI following the use of topical cocaine during endonasal surgery in a patient without any known history of cardiac disease or hypertension, and who had patent coronary vessels on subsequent angiography.