1/14. Aortic thrombosis associated with cocaine use: report of two cases.cocaine use has been associated with many vascular complications which may involve the carotid, coronary, and renal vascular beds. cocaine may also cause venous thrombosis. This report describes a new entity of cocaine-induced aortic thrombosis. On the basis of clinical findings and response to treatment, a therapeutic algorithm is presented.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
2/14. Total occlusion of the left main coronary artery in a young cocaine user.A young woman, currently user of cocaine, was admitted because of acute myocardial infarction with cardiogenic shock. The coronary arteriography revealed total occlusion of the left main coronary artery. Despite the use of an intraaortic counterpulsation balloon and successful percutaneous transluminal coronary angioplasty, she developed electromechanical dissociation, unresponsive to resuscitation manoeuvres.- - - - - - - - - - ranking = 7keywords = coronary (Clic here for more details about this article) |
3/14. role of the vascular endothelium in patients with angina pectoris or acute myocardial infarction with normal coronary arteries.chest pain with normal coronary angiograms is a relatively common syndrome. The mode of presentation of this syndrome includes patients with syndrome X and patients with an acute myocardial infarction and angiographically normal coronary arteries. Different mechanisms have been proposed to elucidate the exact cause and to explain the various clinical presentations in these patients. Abnormalities of pain perception and the presence of oesophageal dysmotility have all been reported in patients with syndrome X. In situ thrombosis or embolization with subsequent clot lysis and recanalization, coronary artery spasm, cocaine abuse, and viral myocarditis have been described as potential mechanisms responsible for an acute myocardial infarction in patients with angiographically normal coronary arteries. Recent data suggest that both microvascular and epicardial endothelial dysfunction may play an important role in the pathophysiological mechanism of the syndrome of stable angina or acute myocardial infarction with normal coronary arteries.- - - - - - - - - - ranking = 9keywords = coronary (Clic here for more details about this article) |
4/14. cocaine-induced bradyarrhythmia: an unsuspected cause of syncope.cocaine use is associated with adverse events in nearly every organ system. Cardiovascular complications include hemorrhagic and ischemic stroke, aortic dissection, cardiomyopathy, accelerated coronary artery disease, myocardial infarction, and sudden cardiac death. syncope may be the presenting symptom in these conditions. However, cocaine-induced bradyarrhythmias have been scarcely mentioned. As this case exemplifies, clinicians should be aware of this association when they evaluate syncope, especially in young patients.- - - - - - - - - - ranking = 1keywords = coronary (Clic here for more details about this article) |
5/14. Continuous high-dose intracoronary nitroglycerin infusion in refractory coronary vasospasm.This case report illustrates the use of continuous high-dose intracoronary nitroglycerin infusion through a 6 French coronary guiding catheter in the treatment of a patient with cocaine-induced refractory coronary vasospasm.- - - - - - - - - - ranking = 11keywords = coronary (Clic here for more details about this article) |
6/14. situs inversus totalis and single coronary ostium: A coincidence or a pattern?situs inversus totalis and single coronary ostium are rare congenital anomalies, and no ontogenic connection has been described between them. Only three cases of association of single coronary ostium and situs inversus have been reported in the literature, all found on angiography. Here we present the first case of this association discovered at autopsy. Based on the apparently higher than expected frequency of this finding, an underlying pathologic connection between these conditions is proposed.- - - - - - - - - - ranking = 6keywords = coronary (Clic here for more details about this article) |
7/14. cocaine abuse and coronary artery dissection.A 33-year-old man with a history of recent cocaine use presented with dissection of the left main coronary artery extending distally to involve the left anterior descending (LAD) and circumflex arteries. He required emergency four-vessel aortocoronary bypass, which was uncomplicated.- - - - - - - - - - ranking = 6keywords = coronary (Clic here for more details about this article) |
8/14. Spontaneous acute coronary dissection after cocaine abuse in a young woman.Spontaneous coronary artery dissection is an unusual trigger for acute coronary syndrome or sudden death, occurring more frequently in relatively young people and mainly in the female sex. The underlying mechanism is not completely understood, but predisposing factors may include metabolism and collagen synthesis disorders. The case of a 34-year-old woman who underwent coronary angiography for acute anterolateral myocardial ischemia after cocaine abuse is reported. dissection of the left main trunk extending to both proximal descending anterior and circumflex arteries was detected and the patient was promptly and successfully managed with tirofiban hydrochloride infusion and urgent coronary artery bypass grafting.- - - - - - - - - - ranking = 8keywords = coronary (Clic here for more details about this article) |
9/14. The cocaine-abused heart.Recreational use of cocaine dates back to the Incas in south america 5000 years ago. cocaine is derived from the leaves of Erythroxylon coca, a shrub native to south america. In the late 1800s, Sigmund Freud popularized the drug in europe. He used cocaine to treat depression, asthma, cachexia, and for overcoming morphine addiction. Also in this period cocaine rapidly gained acceptance in surgical procedures as a local anesthetic and vasoconstrictor. cocaine reached the united states in the early 1900s, and its popularity led President Taft to declare it public enemy number one in 1910. cocaine became popular again in the 1980s. Currently cocaine use is responsible for more ED visits then any of the other illicit drugs. Because most cocaine users are young, they are at a lower risk for coronary artery atherosclerotic disease. An estimated 25 million people between the ages of 26 and 34 years have used cocaine at least once, 20% were women and 30% men. Habitual users of cocaine are estimated to number 1.5 million. Most cocaine-induced chest pains do not progress to MI, and in fact many originate in the chest wall. The chest pains due to cocaine, however, are induced by myocardial ischemia, a result of vasospasm and not a thrombotic occlusion of a coronary artery that has a ruptured atheromatous plaque. ECG findings can be misleading in the diagnosis because the early repolarization syndrome, a normal variant, is a frequent finding in young African American men. Measurement of cardiac troponin levels is the most reliable diagnostic test. percutaneous coronary intervention and angioplasty, rather than thrombolysis, is the treatment of choice because intense coronary vasospasm is the primary pathophysiology in cocaine-induced MI.- - - - - - - - - - ranking = 4keywords = coronary (Clic here for more details about this article) |
10/14. Multivessel coronary thrombosis secondary to cocaine use successfully treated with multivessel primary angioplasty.cocaine use has been associated with a significant risk of myocardial ischemia and myocardial infarction (MI). The previous approach to the treatment of cocaine-induced MI focused on medical treatment with verapamil, nitroglycerine and thrombolytics. Percutaneous revascularization for the cocaine-associated MI has been reported and is the preferred treatment modality. Identification of culprit vessel in the patients presenting with acute myocardial infarction associated with cocaine use is problematic owing to the frequent presence of baseline electrocardiogram (ECG) changes. Chronic cocaine use predisposes to diffuse coronary vasculopathy and may cause systemic alteration of coagulation parameters. Multivessel coronary thrombosis presenting as myocardial infarction associated with cocaine use has not been previously reported. This study describes a case of multivessel coronary thrombosis caused by cocaine ingestion successfully treated with multivessel primary angioplasty.- - - - - - - - - - ranking = 7keywords = coronary (Clic here for more details about this article) |
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