Dilated cardiomyopathy secondary to chronic cocaine abuse: a case report

BMC Research Notes

German T Hernandez²  Pedro A Blandon²  Shajeea Ajmal¹  Remi Trien¹  Emmanuel Rodriguez¹  Haider Alkhateeb¹  Sarmad Said¹  Chad J Cooper¹ 

[1] Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center at El Paso, El Paso, Texas, USA;Division of Nephrology & Hypertension, Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center at El Paso, El Paso, Texas, USA

关键词: Catecholamine;    Congestive heart failure;    Dilated cardiomyopathy;    Cocaine;   

Others  :  1138253
DOI  :  10.1186/1756-0500-6-536

 received in 2013-10-18, accepted in 2013-12-09,  发布年份 2013

【 摘 要 】

Background

Cocaine is a potent sympathomimetic agent associated with the development of possible fatal cardiovascular complications. Dysrhythmias, acute myocardial infarction, hypertension and dilated cardiomyopathy are just some of many cardiovascular effects related to the abuse of cocaine.

Case presentation

A 38-year-old Hispanic male with a past medical history of hypertension presented with a chief complaint of progressive shortness of breath. The patient confessed to the use of cocaine for almost 18 years once per week. On examination he was hypertensive and tachycardic with a systolic murmur over the 5th intercostal space at the level of the left mid-clavicular line. Laboratory workup revealed an elevated Brain natriuretic peptide; urine toxicology was positive for cocaine. 2D-echocardiogram showed dilated cardiomyopathy. Cardiac catheterization excluded angioischemic cause. He was managed medically and subsequently discharged with drug rehabilitation. On follow-up diagnostic evaluation after 5 months of cocaine cessation, his ejection function improved significantly.

Conclusion

The exact incidence of cocaine related cardiomyopathy is unknown and likely underreported. The clinical course is abrupt and comparatively similar to other types of cardiomyopathy. The management is like other forms of cardiomyopathy; however β-blockers should be avoided. The myocardial dysfunction is reversible with abstaining from additional cocaine ingestion. Non-invasive testing should be performed after several months to re-evaluate the treatment response.

【 授权许可】

   
2013 Cooper et al.; licensee BioMed Central Ltd.

【 图 表 】

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