Rescue extracorporeal circulation as bridge to recovery in fulminant cocaine-induced heart failure

Cocaine is an increasing cause of admission in the emergency room. The widespread abuse of this drug during the last decade in the USA is now widely emerging in Europe. Because of its various cardio-vascular complications, cocaine is one of the most death-related drugs known at this time. The following report describes the dramatic case of a young man polydrug addict presenting at our institution with life-threatening acute heart failure that developed shortly after his very first cocaine intake. Because of the lack of response to intensive medical treatment, we decided to perform a percutaneous extracorporeal circulation membranous oxygenation (ECMO) that allowed survival and rapid left ventricular function recovery. This report highlights cocaine as a rising trigger of acute heart failure in young people and is, to the best of our knowledge, the first report that illustrates ECMO as an effective hemodynamic support in the course of fulminant cocaine-induced cardiomyopathy. (C) 2008 Elsevier Ireland Ltd. All rights reserved.