The heart in cocaine dependence

The heart in cocaine dependence: Gross, focal scars in myocardium, a woman in twenties with sudden death
Image courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

WikiDoc Resources for The heart in cocaine dependence

Articles

Most recent articles on The heart in cocaine dependence

Most cited articles on The heart in cocaine dependence

Review articles on The heart in cocaine dependence

Articles on The heart in cocaine dependence in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on The heart in cocaine dependence

Images of The heart in cocaine dependence

Photos of The heart in cocaine dependence

Podcasts & MP3s on The heart in cocaine dependence

Videos on The heart in cocaine dependence

Evidence Based Medicine

Cochrane Collaboration on The heart in cocaine dependence

Bandolier on The heart in cocaine dependence

TRIP on The heart in cocaine dependence

Clinical Trials

Ongoing Trials on The heart in cocaine dependence at Clinical Trials.gov

Trial results on The heart in cocaine dependence

Clinical Trials on The heart in cocaine dependence at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on The heart in cocaine dependence

NICE Guidance on The heart in cocaine dependence

NHS PRODIGY Guidance

FDA on The heart in cocaine dependence

CDC on The heart in cocaine dependence

Books

Books on The heart in cocaine dependence

News

The heart in cocaine dependence in the news

Be alerted to news on The heart in cocaine dependence

News trends on The heart in cocaine dependence

Commentary

Blogs on The heart in cocaine dependence

Definitions

Definitions of The heart in cocaine dependence

Patient Resources / Community

Patient resources on The heart in cocaine dependence

Discussion groups on The heart in cocaine dependence

Patient Handouts on The heart in cocaine dependence

Directions to Hospitals Treating The heart in cocaine dependence

Risk calculators and risk factors for The heart in cocaine dependence

Healthcare Provider Resources

Symptoms of The heart in cocaine dependence

Causes & Risk Factors for The heart in cocaine dependence

Diagnostic studies for The heart in cocaine dependence

Treatment of The heart in cocaine dependence

Continuing Medical Education (CME)

CME Programs on The heart in cocaine dependence

International

The heart in cocaine dependence en Espanol

The heart in cocaine dependence en Francais

Business

The heart in cocaine dependence in the Marketplace

Patents on The heart in cocaine dependence

Experimental / Informatics

List of terms related to The heart in cocaine dependence

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Cocaine can cause coronary artery spasms which may lead to a myocardial infarction. This effect can happen randomly to any user. The coronary artery spasms can occur on the user's first usage or any other usage after. The coronary spasms cause the ectopic ventricular foci of the heart to become hypoxic and the extreme irritability can trigger life-threatening ventricular arrhythmias. [1] [2] [3] [4] [5] [6] [7] [8] [9] [10] [11]

## Contents

* 1 Pathological Findings
* 1.1 Gross Images
* 1.2 Microscopic Images
* 2 References

## Pathological Findings

[edit | edit source]

### Gross Images

[edit | edit source]

Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

* Heart: Cocaine dependence: Gross, focal scars in myocardium, a woman in twenties with sudden death.

* Heart: Cocaine dependence: Gross, focal scars in myocardium, a woman in twenties with sudden death.

* Heart: Cocaine dependence: Gross, focal scars in myocardium, a woman in twenties with sudden death.

### Microscopic Images

[edit | edit source]

Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

* Heart: Cocaine dependence: Micro low mag H&E scar in myocardium woman in twenties sudden death

* Heart: Cocaine dependence: Micro med mag small artery in myocardium with marked intimal thickening questionable evidence of previous injury due to spasm. Specimen taken from a woman in twenties after sudden death.

* Heart: Cocaine dependence: Micro high mag small artery in myocardium with marked intimal thickening and vacuolated smooth muscle cells in media questionable evidence of previous spasm woman in twenties sudden death

* Heart: Cocaine dependence: Micro low mag scars in myocardium. Specimen taken from a woman in twenties after sudden death.

* Heart: Cocaine dependence: Micro, high mag, H&E, small artery in epicardium with vacuolated medial smooth muscle cells possible evidence of previous spasm. Specimen taken from a woman in twenties after sudden death.

* Heart: Cocaine dependence: Micro, high mag, H&E, small artery in epicardium with vacuolated medial smooth muscle cells possible evidence of previous spasm. Specimen taken from a woman in twenties after sudden death.

* Micro, med mag small, myocardial artery intimal thickening due to vasospasm. Specimen taken from a woman in twenties after sudden death.

## References

[edit | edit source]

1. ↑ Virmani R. Cocaine-associated cardiovascular disease: clinical and pathological aspects. NIDA Res Monogr 1991;108:220–9
2. ↑ Lange RA, Hillis LD. Cardiovascular complications of cocaine use. N Engl J Med 2001;345:351– 8.
3. ↑ Rump AF, Theisohn M, Klaus W. The pathophysiology of cocaine cardiotoxicity. Forensic Sci Int 1995;71:103–15.
4. ↑ Brickner ME, Willard JE, Eichhorn EJ, et al. Left ventricular hypertrophy associated with chronic cocaine abuse. Circulation 1991;84:1130–5.
5. ↑ Majid PA, Patel B, Kim HS, et al. An angiographic and histologic study of cocaine-induced chest pain. Am J Cardiol 1990;65:812–4.
6. ↑ Hollander JE. The management of cocaine-associated myocardial ischemia. N Engl J Med 1995;333:1267–72.
7. ↑ Mouhaffel AH, Madu EC, Satmary WA, et al. Cardiovascular complications of cocaine. Chest 1995;107:1426–34.
8. ↑ Perrone J, Hollander JE, De Roos F. Cardiovascular risk factors and atherosclerosis in children and young adults. N Engl J Med 1998;339:1083–4.
9. ↑ Kloner RA, Hale S, Alker K, et al. The effects of acute and chronic cocaine use on the heart. Circulation 1992;85:407–19.
10. ↑ Kolodgie FD, Wilson PS, Mergner WJ, et al. Cocaine-induced increase in the permeability function of human vascular endothelial cell monolayers. Exp Mol Pathol 1999;66:109–22.
11. ↑ Schindler CW. Cocaine and cardiovascular toxicity. Addict Biol 1996;1:31–47.

* v
* t
* e

Electrocardiography

Overview|

History of the EKG • EKG interpretation basics • Normal sinus rhythm

EKG Complexes|

P wave • QRS complex • ST Segment • T wave • T wave alternans • Tombstone T wave • U wave

Osborn wave • H wave • K wave • Delta wave

NSSTW changes

EKG Intervals|

PR Interval • QRS Interval • ST Interval • QT Interval

Conduction System & Bradycardia|

Cardiac pacemaker • SA node • AV node• Bundle of His • Purkinje fibers • Sinus bradycardia • First Degree AV Block • Second Degree AV Block • Complete or Third-Degree AV Block • Concealed conduction • AV Junctional Rhythms • LBBB • LAHB • LPHB • RBBB • Trifascicular block

Atrial Arrhythmias|

Sinus tachycardia • Premature Atrial Contractions (PACs) • Ectopic Atrial Rhythm • Paroxysmal Atrial Tachycardia (PAT) • Paroxysmal Atrial Tachycardia (PAT) with Block • Multifocal Atrial Tachycardia (MAT) • Atrial Flutter • Atrial Fibrillation • Wandering atrial pacemaker

Ventricular Arrhythmias|

Differential Diagnosis of Tachycardia with a Wide QRS Complex • Accelerated Idioventricular Rhythm • Ventricular Parasystole • Premature Ventricular Contractions (PVCs) • Ventricular tachycardia • Ventricular Fibrillation • Sudden cardiac death

EKG Abnormalities in Disease States|

Hypertrophy & Dilatation • Right atrial enlargement • Left atrial enlargement • Biatrial enlargement • Left Ventricular Hypertrophy • Right Ventricular Hypertrophy • Biventricular Hypertrophy •

Acute myocardial infarction • NSTEMI • STEMI • Tombstone ST elevation • Right ventricular myocardial infarction • Atrial infarction

Pre-excitation Syndromes • Wolff-Parkinson-White Syndrome • Lown Ganong Levine Syndrome • Mahaim Type Preexcitation

Cardiomyopathies • Arrhythmogenic Right Ventricular Dysplasia • Dilated Cardiomyopathy • Hypertrophic Cardiomyopathy

Drug Effects on the EKG • Adenosine • β-blockers • Digitalis • Quinidine • Procainamide • Disopyramide • Lidocaine • Tocainide and Mexiletine • Phenytoin • Encainide, Flecainide and Propafenone • Amiodarone • Bretylium • Ca Channel Blockers • Phenothiazines • Tricyclic Antidepressants • Lithium

Congenital Heart Disease • Dextrocardia • Atrial Septal Defect • Ventricular Septal Defect • Tetralogy of Fallot • Conjoined Twins or Siamese Twins • Congenital heart block

Electrolyte Disturbances • Hyperkalemia • Hypokalemia • Hypercalcemia • Hypocalcemia • Nonspecific Changes

Other Heart Diseases • Pericarditis • Myocarditis • Tamponade • Heart Transplantation • Sick Sinus Syndrome • Long QT Syndrome

Inherited Disease • Brugada Syndrome

Systemic Diseases • CNS Disease • Cardiac Tumors

Heart Transplantation • EKG Changes in patient with Heart Transplantation

Exogenous Effects • Hypothermia • Chest Trauma • Insect Bites • Electric Injuries

Technical Issues and Potential Errors in Interpretation|

Artifacts • Lead Placement Errors • The EKG in a Patient with a Pacemaker • EKG in athletes

* v
* t
* e

Cardiovascular disease (heart)

Ischaemic|

| Coronary disease|

* Coronary artery disease (CAD)
* Coronary artery aneurysm
* Spontaneous coronary artery dissection (SCAD)
* Coronary thrombosis
* Coronary vasospasm
* Myocardial bridge

|

Active ischemia|

* Angina pectoris
* Prinzmetal's angina
* Stable angina
* Acute coronary syndrome
* Myocardial infarction
* Unstable angina

Sequelae|

* hours
* Hibernating myocardium
* Myocardial stunning
* days
* Myocardial rupture
* weeks
* Aneurysm of heart / Ventricular aneurysm
* Dressler syndrome

Layers|

| Pericardium|

* Pericarditis
* Acute
* Chronic / Constrictive
* Pericardial effusion
* Cardiac tamponade
* Hemopericardium

|

Myocardium|

* Myocarditis
* Chagas disease
* Cardiomyopathy
* Dilated
* Alcoholic
* Hypertrophic
* Tachycardia-induced
* Restrictive
* Loeffler endocarditis
* Cardiac amyloidosis
* Endocardial fibroelastosis
* Arrhythmogenic right ventricular dysplasia

Endocardium /
valves|

| Endocarditis|

* infective endocarditis
* Subacute bacterial endocarditis
* non-infective endocarditis
* Libman–Sacks endocarditis
* Nonbacterial thrombotic endocarditis

|

Valves|

* mitral
* regurgitation
* prolapse
* stenosis
* aortic
* stenosis
* insufficiency
* tricuspid
* stenosis
* insufficiency
* pulmonary
* stenosis
* insufficiency

Conduction /
arrhythmia|

| Bradycardia|

* Sinus bradycardia
* Sick sinus syndrome
* Heart block: Sinoatrial
* AV
* 1°
* 2°
* 3°
* Intraventricular
* Bundle branch block
* Right
* Left
* Left anterior fascicle
* Left posterior fascicle
* Bifascicular
* Trifascicular
* Adams–Stokes syndrome

|

Tachycardia
(paroxysmal and sinus)|

| Supraventricular|

* Atrial
* Multifocal
* Junctional
* AV nodal reentrant
* Junctional ectopic

|

Ventricular|

* Accelerated idioventricular rhythm
* Catecholaminergic polymorphic
* Torsades de pointes

Premature contraction|

* Atrial
* Junctional
* Ventricular

Pre-excitation syndrome|

* Lown–Ganong–Levine
* Wolff–Parkinson–White

Flutter / fibrillation|

* Atrial flutter
* Ventricular flutter
* Atrial fibrillation
* Familial
* Ventricular fibrillation

Pacemaker|

* Ectopic pacemaker / Ectopic beat
* Multifocal atrial tachycardia
* Pacemaker syndrome
* Parasystole
* Wandering atrial pacemaker

Long QT syndrome|

* Andersen–Tawil
* Jervell and Lange-Nielsen
* Romano–Ward

Cardiac arrest|

* Sudden cardiac death
* Asystole
* Pulseless electrical activity
* Sinoatrial arrest

Other / ungrouped|

* hexaxial reference system
* Right axis deviation
* Left axis deviation
* QT
* Short QT syndrome
* T
* T wave alternans
* ST
* Osborn wave
* ST elevation
* ST depression
* Strain pattern

Cardiomegaly|

* Ventricular hypertrophy
* Left
* Right / Cor pulmonale
* Atrial enlargement
* Left
* Right
* Athletic heart syndrome

Other|

* Cardiac fibrosis
* Heart failure
* Diastolic heart failure
* Cardiac asthma
* Rheumatic fever

Template:WikiDoc Sources
*[v]: View this template
*[t]: Discuss this template
*[e]: Edit this template