Dilated cardiomyopathy and cocaine abuse. Report of two cases

Effects of cocaine on epicardial coronary artery reactivity in miniature swine after endothelial injury and high cholesterol feeding. In vivo and in vitro analysis.

“…In this regard, Flores et al (36) have recently published data from patients with coronary artery disease demonstrating that intranasal cocaine causes enhanced vasoconstriction at sites of atherosclerotic narrowing of the large epicardial coronary artery. However, it remains to be determined if other factors besides coronary vasospasm mediate development of cocaine's cardiac toxicity, including cardiomyopathy (37). These factors could indicate release of catecholamines from nerve endings or a direct action of cocaine on myocardial or vascular receptors.…”

Exacerbation of Viral Myocarditis by Tobacco Smoke: The Catecholamine Hypothesis

“…Cocaine has also been reported to increase natural killer cell activity (Van Dyke et al, 1986). Both lymphocytic and eosinophilic myocarditis have been reported in cocaine abusers (Virmani et al, 1988;Tazelaar et al, 1987) and heart failure is a common finding (Weiner et al, 1986;Duell, 1987). Alternatively, "possibility (b)", cocaine may exacerbate viral myocarditis by permitting enhanced viral replication of the viral agent once it has penetrated the cell membrane.…”

Chronic Exposure to Cocaine Binging Predisposes to an Accelerated Course of Dilated Cardiomyopathy in Conscious Dogs following Rapid Ventricular Pacing

“…There have been increasing numbers of reports of dilated cardiomyopathy in cocaine abusers. Wiener et al (1986) were the first to describe the occurrence of DCM in the absence of atherosclerotic coronary artery disease in two patients who were cocaine abusers.…”

“…There have been increasing numbers of reports of dilated cardiomyopathy in cocaine abusers. Wiener et al (1986) were the first to describe the occurrence of DCM in the absence of atherosclerotic coronary artery disease in two patients who were cocaine abusers.Chronic cocaine use in young men who were normotensive and had no symptoms or signs of heart diseases had electrocardiographic and echocardiographic abnormalities including LV hypertrophy (54%), LVEF Ͻ0.45 (4%), increased QRS voltage (23%), and episodes of ST-segment elevation on ambulatory monitoring (33%) (Chakko and Myerburg, 1995). However, the mechanism whereby chronic cocaine use predisposes to myocardial injury remains incompletely understood.…”

“…The effects of cocaine on the cardiovascular system are multifaceted and remain incompletely understood. Cardiovascular manifestations of cocaine abuse include chest pain, myocardial ischemia and infarction, arrhythmias, infective endocarditis, aortic dissection and development of dilated cardiomyopathy, and heart failure (Wiener et al, 1986;Kloner et al, 1992;Mouhaffel et al, 1995). There have been increasing numbers of reports of dilated cardiomyopathy in cocaine abusers.…”