Cocaine and Cardiotoxicity: A Literature Review

Long-term cocaine use, as well as acute cocaine use, is associated with adverse cardiovascular consequences, including arrhythmias, angina, myocardial infarction, heart failure, and other conditions. Over the long term, cocaine can result in structural changes to the heart such as increased left-ventricular mass and decreased left-ventricular end-diastolic volume. Patients arriving with cocaine-associated cardiovascular complaints may not be forthcoming about their cocaine or polysubstance abuse or may be unresponsive. The role of beta-blockers, a first-line treatment for many forms of heart disease, is controversial in this population. Cocaine is a powerful sympathomimetic agent, and it was thought that beta-blockade would result in unopposed alpha-adrenergic stimulation and adverse consequences. A number of small, singlecenter, retrospective and observational studies suggest that beta-blockers may be safe, effective, and beneficial in this population. Further study is needed to clarify the role of beta-blockers in this population.

Automated summary

Both long-term and acute cocaine use can lead to adverse cardiovascular consequences, with potential conditions including arrhythmias, angina, myocardial infarction, and heart failure. Patients with cocaine-associated cardiovascular complaints may not disclose their substance abuse history, and the use of beta-blockers in this population remains controversial, with some studies suggesting potential safety and benefits while others raise concerns about adverse consequences. Further research is needed to clarify the role of beta-blockers in individuals with cocaine-related cardiovascular issues.