DALLAS — Younger ER patients with heart attack symptoms should be asked if they’ve recently used cocaine, which can cause similar chest pain, the American Heart Association warns doctors.
Honesty can be a matter of life or death: Some heart attack treatments, such as clot-busting drugs and betablockers, can be deadly to someone using cocaine.
The drug can cause chest pain, shortness of breath, anxiety, palpitations, dizziness, nausea and heavy sweating — all symptoms of a heart attack.
“Not knowing what you are dealing with and giving the wrong therapies could mean death rather than benefit,” said Dr. James Reiffel, professor of clinical medicine at Columbia University Medical Center/New York Presbyterian Hospital.
The number of cocaine-related users visiting ERs rose 47 percent from 1995 to 2002, increasing from 135,711 to 199,198, according to the government’s Substance Abuse and Mental Health Services Administration.
Cocaine can cause a heart attack, but only about 1 percent to 6 percent of patients with cocaine-associated chest pain actually have a heart attack, the American Heart Association says. Still, doctors say it’s important for anyone with chest pain to get it checked out.
Cocaine increases blood pressure and heart rate, constricting arteries into the heart, said Dr. James McCord, cardiology director of the chest pain unit for the Henry Ford Health System in Detroit.
“Your heart rate goes up because your heart needs more oxygen, then it shrinks the arteries to the heart,” McCord said.
The statement says that since most cocaine-associated chest pain isn’t a heart attack, such patients should be monitored instead of being admitted to the hospital. They would have an electrocardiogram and other tests to rule out a heart attack.
Reiffel said doctors should explain why it’s important to know if a patient is using cocaine. He said admitting use of an illegal substance is confidential information that won’t be reported to law enforcement. “The caregiver is not here to judge.”
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