Doctors To Ask Patients With Heart Attack Signs About Cocaine

The American Heart Association is warning emergency room doctors to ask patients that show signs and symptoms of heart attacks if they used cocaine. It's a matter of life and death. Treatments used for heart patients can be lethal for those using cocaine.

New guidelines were published online on Monday in the AHA journal Circulation. Cocaine can cause chest pain, shortness of breath, anxiety, palpitations, dizziness, nausea and heavy sweating. All of these are also the signs of a heart attack.

"Not knowing what you are dealing with and giving the wrong therapies could mean death rather than benefit," said Dr. James Reiffel, professor of clinical medicine at Columbia University Medical Center/New York Presbyterian Hospital.

The case load of cocaine related users going to the ER rose 47 percent from 1995 to 2002 with symptoms that closely resemble a heart attack. While cocaine itself can cause a heart attack it is a rare occurrence happening in only 1 to 6 percent of those who suffer chest pain.

Your heart rate goes up because your heart needs more oxygen, then it shrinks the arteries to the heart," McCord said.

Those using cocaine are at risk if they have certain treatments meant for heart attack sufferers.

Clot-busting drugs carry an extra risk of bleeding into the brain in patients whose blood pressure is high due to cocaine use.

Betablockers that can lower blood pressure without constricting arteries in typical heart attack patients have the opposite effect in cocaine users, raising blood pressure and squeezing cocaine-narrowed arteries.

Also in the new guidelines are the use of stents with heart attack victims who use cocaine. Those who use the drug should get a bare metal stent instead of the drug coated one. This is because the drug coated stent requires medicine to prevent new blockages. Most chronic drug users do not take their medicines reliably.

"I think an ideal scenario would be someone whose job is to talk to them about this - explain the extent of the health problems, give them information about resources to help them quit cocaine," McCord said.