Síndrome coronario agudo por cocaína. Manejo inicial en el servicio de urgencias

Abstract

Objectives Cocaine consumption frequently produces cardiovascular problems. We analyse the case of a patient with cardiac symptoms after consuming cocaine. Material and methods The case of a 41 year old male in A&E with acute chest pain that does not cease spontaneously after sniffing cocaine is examined. Results On admittance, a physical examination and electrocardiogram are carried out. The corresponding treatment is then given with a complete remission of the symptoms, the alterations in the ECG and a normalization of life signs. The diagnosis of secondary coronary vasospasm due to cocaine is established. Conclusions Cocaine consumption, in some cases, provokes cardiac vasospasm, in both vessels with atheromatosis lesions visible in x-rays and apparently healthy coronary arteries. The greater the dosis or purity of the cocaine, the greater the vasospasm. The appearance of a deferred acute coronary syndrome (hours or days) following acute cocaine intoxication has also been described.