Acute Medicine | Cardiovascular | Pathophysiology presentations and management of cocaine-related chest pain

Pathophysiology Presentations and Management of Cocaine-related Chest Pain
Session Overview
Description
This session describes the pathophysiology, presentations and management of cocaine-related chest pain.

Learning Objectives
By the end of this session you will be able to:

• Describe what cocaine is and the prevalence of its use (as reported in the 2009 UN World Drug Report)
• List the causes of cocaine-related acute coronary syndrome
• Explain how to investigate a patient with suspected cocaine-related acute coronary syndrome
• Describe the management of cocaine-related acute coronary syndrome and state how this differs from classical atherosclerotic acute coronary syndrome

Cocaine is a natural alkaloid that is found in the leaves of the Erythroxylum coca shrub (Fig 1). It is found predominately in Central and South America, including Columbia, Peru and Bolivia.

Cocaine use is common. The latest UN World Drug Report estimates an annual prevalence rate of 0.4-0.5% of the world population [1]. This use is predominately in the western/developed world (Fig 2).

Possession, sale and distribution of cocaine is controlled under the Misuse of Drugs Act (1971), as a Class A drug [2].