How is myocardial infarction (MI) treated in cocaine toxicity?

Updated: Sep 01, 2018
  • Author: Lynn Barkley Burnett, MD, EdD, LLB(c); Chief Editor: Sage W Wiener, MD  more...
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Answer

Chest pain may result from musculoskeletal, cardiovascular, pulmonary, or other causes. Risk of myocardial infarction is highest within the first hour following cocaine use. [53] In patients with cocaine-related chest pain, assume that cardiac ischemia is present until this is proven otherwise. Accordingly, the ED approach to such patients, in addition to oxygen, intravenous access, and monitoring, includes the steps outlined below.

  • Perform 12-lead ECG.
  • Obtain chest imaging.
  • Direct the initial pharmacologic approach to suspected cocaine-related myocardial ischemia at increasing coronary blood flow and decreasing sympathetic output.

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