Cocaine induced MI

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source:HTTP://WWW.NCBI.NLM.NIH.GOV/PMC/ARTICLES/PMC2111405/

CONCLUSION 

Cocaine use may lead to the development of acute myocardial infarction, but the incidence of infarction is difficult to determine, and varies widely in the literature. Some, but not all, studies suggest that cocaine hastens the development of coronary artery atherosclerosis. However, the most plausible mechanism for the development of myocardial infarction in the cocaine user is coronary artery spasm at a time when oxygen demand is increased due to an increase in heart rate and blood pressure that are accompanied by platelet activation, and together culminate in coronary artery occlusion, particularly if the patient has underlying coronary artery disease (figure 1▶). Thrombolytic therapy or acute intervention should be initiated promptly after assessing for the risk of bleeding and other major complications, such as aortic dissection, severe hypertension or intracerebral hemorrhage. Acute beta blocker use should be viewed with caution, since it may lead to a decrease in coronary flow and an increase in coronary artery resistance. The most important long-term interventions are to enter the patient into a substance abuse program and to educate the patient about the harmful effects that cocaine has upon the heart.