Acute aortic dissection related to crack cocaine
Acute aortic dissection related to crack cocaine
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DOI：
10.1161/01.cir.0000012524.44897.3a
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发表时间：
2002-04-02
期刊：
影响因子：
37.8
通讯作者：
Waters, DD
中科院分区：
文献类型：
--
作者：
Hsue, PY;Salinas, CL;Waters, DD
背景 - 尽管单个病例报告描述了与可卡因使用相关的急性主动脉夹层，但这种情况并未得到广泛认可，并且可卡因相关主动脉夹层的特征尚未开始定义。 方法和结果 - 我们回顾了 1981 年至 2001 年所有可用的医院图表，并进行了 ICD-9 诊断：主动脉夹层。在38例急性主动脉夹层病例中，14例（37%）与使用可卡因有关。 13 例吸食快克可卡因，1 例吸食粉末可卡因。使用可卡因和出现症状之间的平均间隔为 12 小时（范围：0 至 24）。与未使用可卡因的主动脉夹层患者相比，与可卡因相关的夹层患者更年轻，更有可能接受手术。可卡因组中的大多数是黑人，有未经治疗的高血压病史。然而，两组在其他方面没有差异，包括夹层类型。结论——在内城区人群中，使用强效可卡因导致的急性主动脉夹层很常见，可能是由于突然、短暂、严重的高血压和儿茶酚胺释放造成的。对于患有严重胸痛的可卡因使用者，应考虑这一诊断。
Background-Although single case reports have described acute aortic dissection in relation to cocaine use, this condition is not widely recognized, and the features of cocaine-related aortic dissection have not begin defined.Methods and Results-We reviewed all available hospital charts from 1981 to 2001 with the ICD-9 diagnosis of aortic: dissection. Among the 38 cases of acute aortic dissection, 14 (37%) were related to cocaine use. Crack cocaine was smoked in 13 cases and powder cocaine was snorted in 1 case. The mean interval between cocaine use and the onset of symptoms was 12 hours (range, 0 to 24). Patients with cocaine-related dissection were much younger and more likely to undergo surgery compared with patients with aortic dissection without cocaine use. Most in the cocaine group were black, with a history of untreated hypertension. However, the two groups did not differ in other respects, including dissection type.Conclusions-In an inner city population, acute aortic dissection in the setting of crack cocaine use is common, presumably as a consequence of abrupt, transient, severe hypertension and catecholamine release. This diagnosis should be considered in cocaine users with severe chest pain.