Cardiovascular manifestations of substance abuse part 1: cocaine.
Cardiovascular manifestations of substance abuse part 1: cocaine.
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DOI：
10.1097/01.hdx.0000074519.43281.fa
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发表时间：
2003-05-01
期刊：
影响因子：
--
通讯作者：
Ismail, Anjum
中科院分区：
文献类型：
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作者：
Frishman, William H;Del Vecchio, Alexander;Ismail, Anjum
可卡因滥用与多种心血管疾病有关，包括心肌梗死、夹层、左心室肥大、心律失常、猝死和心肌病。钴具有增强儿茶酚胺的生理作用的作用，并对与局部麻醉性质相关的电压依赖性钠离子通道具有直接作用。可卡因的作用可以随着饮酒而增强。可卡因引起的急性心肌缺血可能与原位血栓形成和/或冠状动脉痉挛有关。可卡因诱发心肌梗死的治疗策略包括抗血小板治疗、溶栓和血管扩张剂（如硝酸盐、硝苯地平）。除非同时给予血管扩张剂治疗，否则不应使用β-肾上腺素能阻滞剂。
Substance abuse with cocaine is associated with multiple cardiovascular conditions, including myocardial infarction, dissection, left ventricular hypertrophy, arrhythmias, sudden death, and cardiomyopathy. Cocaine has effects to potentiate the physiologic actions of catecholamines and has direct effects on voltage-dependent sodium ion channels related to local anesthetic properties. The effects of cocaine can be augmented with concomitant alcohol consumption. Acute myocardial ischemia caused by cocaine may be related to in situ thromboisis and/or coronary vasospasm. Treatment strategies for cocaine-induced myocardial infarction would include antiplatelet therapy, thrombolysis, and vasodilators (eg, nitrates, nifedipine). Beta-adrenergic blockers should not be used unless concomitant vasodilator therapy is given.