This week the AMA released new guidelines for emergency room doctors warning that heart attack symptoms in younger patients with no risk factors for heart disease can be caused by cocaine use. Doctors should ask these patients if they have recently used cocaine, the AMA says.
The AMA recommends monitoring these patients instead of admitting them to the hospital, because most cocaine-associated chest pain is not a heart attack. They should be given an electrocardiogram and other tests to rule out heart attack.
Typical Treatments Dangerous for Cocaine Users
Two treatments typically given to heart attack victims can be dangerous to someone using cocaine.
Clot-busting drugs, also known as thrombolytics, can lessen the long-term damage from stroke or heart attack, but they risk causing bleeding into the brain in patients whose blood pressure is increased due to using cocaine.
Beta blockers are used to lower blood pressure without constricting arteries in the case of a typical heart attack, but have the exact opposite effect on someone doing cocaine. Beta blockers will increase their blood pressure and constrict their arteries, which are already narrowed by the cocaine use.
Therefore, the AMA recommends that cocaine users tell doctors about their use if they end up in the emergency room. It could be a matter of life or death.
The new American Heart Association guidelines were published in the March 17, 2008 online edition of the journal Circulation.