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[Pearls provided by Dr. Semhar Tewelde]
Cocaine...
1. causes systolic and diastolic dysfunction, arrhythmias, and atherosclerosis even in young users with relatively few cardiac risk factors, typically TIMI risk score <1
2. decreases myocardial contractility and ejection fraction by blocking sodium and potassium channels within the myocardium
3. prolongs the PR, QRS, and QT intervals on the ECG
4. users have a higher overall incidence of MI (odds ratio 3.8 to 6.9)
5. -induced chest pain is associated with acute MI in approx. 6% of cases
6. increases the risk of MI by 24-fold in the first hour after use
7. contributes to approx. 1 of every 4 MIs between 18 and 45 years of age
References
Cardiovascular Effects of Cocaine. Schwartz B, et al. Circulation. 2010;122:2558-2569.