Historique
Article de Périodique
Cocaine-associated chest pain (1991)
(Douleurs thoraciques liées à la cocaïne)
Auteur(s) :
ZIMMERMAN, J. L. ;
DELLINGER R.P. ;
MAJID P.A.
Année
1991
Page(s) :
611-615
Langue(s) :
Anglais
Refs biblio. :
32
Domaine :
Drogues illicites / Illicit drugs
Discipline :
PAT (Pathologie organique / Organic pathology)
Résumé :
FRANÇAIS :
Le but de cette étude rétrospective portant sur 48 patients cocaïnomanes admis pour douleurs thoraciques, est d'analyser les modifications de l'électrocardiogramme (ECG). L'incidence, faible mais réelle, de l'infarctus du myocarde chez ces patients est confirmée. Il existe des modifications chroniques de l'ECG ; l'absence de relations temporelles entre douleurs et tracés électrocardiographiques témoigne probablement d'une ischémie chronique secondaire à des modifications myocardiques induites par l'abus de drogue.
ENGLISH :
Study objectives: To describe the clinical and ECG features of cocaine abusers evaluated in the emergency department and admitted to the medical coronary care unit with chest pain consistent with myocardial ischemia.
Design: A four-month retrospective review of all cocaine abusers who presented to the ED with chest pain and a diagnosis of possible myocardial infarction.
Setting: Urban county hospital.
Type of participants: Forty-eight adult cocaine abusers admitted with chest pain.
Measurements and main results: Patients included 34 men and 14 women with a mean age of 29 ± 7.3 years. The average duration of cocaine abuse in 28 patients for whom it was reported was 5 ± 4.8 years. Chest pain occurred within one hour of cocaine abuse in 13 admissions (27%), more than one hour after abuse in 13 admissions (27%), and it was not recorded in 23 admissions (47%). Initial ECGs were evaluated in all patients and revealed significant repolarization abnormalities consisting of abnormal ST segment elevations in 18 (37%) and T-wave inversions in 20 (41%) that often persisted on subsequent ECGs. Three patients sustained acute myocardial infarctions.
Conclusions: Our findings confirm a small but significant incidence of myocardial infarction in cocaine abusers presenting to the ED with chest pain. The chronicity of cocaine abuse, the persistence of ECG abnormalities, and the variable temporal relationship of chest pain to cocaine abuse suggest possible chronic myocardial changes as etiologies of ischemia.
Le but de cette étude rétrospective portant sur 48 patients cocaïnomanes admis pour douleurs thoraciques, est d'analyser les modifications de l'électrocardiogramme (ECG). L'incidence, faible mais réelle, de l'infarctus du myocarde chez ces patients est confirmée. Il existe des modifications chroniques de l'ECG ; l'absence de relations temporelles entre douleurs et tracés électrocardiographiques témoigne probablement d'une ischémie chronique secondaire à des modifications myocardiques induites par l'abus de drogue.
ENGLISH :
Study objectives: To describe the clinical and ECG features of cocaine abusers evaluated in the emergency department and admitted to the medical coronary care unit with chest pain consistent with myocardial ischemia.
Design: A four-month retrospective review of all cocaine abusers who presented to the ED with chest pain and a diagnosis of possible myocardial infarction.
Setting: Urban county hospital.
Type of participants: Forty-eight adult cocaine abusers admitted with chest pain.
Measurements and main results: Patients included 34 men and 14 women with a mean age of 29 ± 7.3 years. The average duration of cocaine abuse in 28 patients for whom it was reported was 5 ± 4.8 years. Chest pain occurred within one hour of cocaine abuse in 13 admissions (27%), more than one hour after abuse in 13 admissions (27%), and it was not recorded in 23 admissions (47%). Initial ECGs were evaluated in all patients and revealed significant repolarization abnormalities consisting of abnormal ST segment elevations in 18 (37%) and T-wave inversions in 20 (41%) that often persisted on subsequent ECGs. Three patients sustained acute myocardial infarctions.
Conclusions: Our findings confirm a small but significant incidence of myocardial infarction in cocaine abusers presenting to the ED with chest pain. The chronicity of cocaine abuse, the persistence of ECG abnormalities, and the variable temporal relationship of chest pain to cocaine abuse suggest possible chronic myocardial changes as etiologies of ischemia.
Affiliation :
Ben Taub Gen. Hosp., 1502 Taub Loop, Houston, TX 77030
Etats-Unis. United States.
Etats-Unis. United States.