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Cocaine and the Heart

Cocaine Can Damage Your Heart or Cause Sudden Death

By Nancy Larson

Updated October 23, 2008

(LifeWire) - Not only is cocaine physically and psychologically addictive, it can kill you -- even on the first try.

The white powder made from the leaves of the coca plant triggers the release of dopamine (a chemical that brings information to the nervous system), then prevents its reabsorption. While users of the illegal drug report euphoria, confidence and clarity, it can also cause permanent heart damage and heart attack.

Cocaine -- whether snorted, smoked or injected -- affects the heart by causing increased or irregular heartbeat and constricted blood vessels. These conditions can lead to several serious or even fatal outcomes:

  • Heart attack, cardiac arrest and sudden death
  • Myocarditis, or heart muscle damage leading to heart failure
  • Endocarditis, or inflammation of the heart lining
  • Vascular thrombosis, or clots in the coronary arteries
  • Pulmonary edema, or fluid in the lungs
  • Dilated cardiomyopathy, or enlarged heart

While those with heart disease are particularly susceptible to these consequences, they can easily occur in someone with no history of coronary difficulty.

Making a Bad Situation Worse

As harmful as cocaine use is for the heart, it's even worse when combined with cigarettes and alcohol. Cocaine and smoking each exacerbate the other's ability to elevate the heart rate and constrict blood vessels. Cocaine paired with alcohol prompts the liver to make cocaethylene, a substance that steps up cocaine's potential to cause heart strain and sudden death.

Cocaine usually impacts the heart within 18 hours of use, but its effects may be seen immediately or up to four days later. Signs of heart problems caused by cocaine use often include chest pain, trouble breathing, anxiety, palpitations, dizziness and nausea.

Medical personnel need to know when cocaine is involved in a heart-related situation as the presence of the drug can change the course of treatment. Intravenous benzodiazepines -- not given in other heart emergencies -- can minimize cocaine's stimulation and therefore its heart-damaging effects.

Those who stop using cocaine are less likely to experience subsequent heart problems related to the drug. Group therapy in tandem with individual counseling has the greatest chance of helping someone kick a cocaine addiction.


"Cocaine and Heart Damage." healthlink.mcw.edu. 4 Nov. 2004. Medical College of Wisconsin. 14 Oct. 2008 <http://healthlink.mcw.edu/article/921033839.html>. 

"Cocaine." brown.edu. 28 Feb. 2008. Brown University. 14 Oct. 2008 <http://www.brown.edu/Student_Services/Health_Services/Health_Education/atod/od_cocaine.htm>. 

"Cocaine, Marijuana and Other Drugs." americanheart.org. 2008. American Heart Association. 14 Oct. 2008 <http://www.americanheart.org/presenter.jhtml?identifier=4552>. 

McCord, James, et al. "Management of Cocaine-Associated Chest Pain and Myocardial Infarction." Circulation 117:(2008):1897-1907. 14 Oct. 2008 <http://circ.ahajournals.org/cgi/content/short/117/14/1897>. 

"This Is Your Heart on Drugs: Study May Help ER Doctors Identify and Treat Chest Pain Caused by Cocaine." med.umich.edu. 5 Feb. 2003. University of Michigan Health System. 14 Oct. 2008 <http://www.med.umich.edu/opm/newspage/2003/cocaineheart.htm>.

LifeWire, a part of The New York Times Company, provides original and syndicated online lifestyle content. Nancy Larson is a St. Louis-based freelance writer whose work has appeared in dozens of local and national print and online publications, including CNN.com, The Weather Channel, Health magazine and The Advocate.

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