Illicit drugs and their impact on cardiovascular pathology

Open access


The use of illicit drugs has dramatically increased during the past years. Consequently, the number of presentations at the emergency departments due to the adverse effects of the illicit drugs has also increased. This review discusses the cardiovascular effects of cocaine, opiates and opioids, cannabinoids, amphetamines, methamphetamines and hallucinogens as we consider that it is essential for a clinician to be aware of them and understand their mechanisms in order to optimize the therapeutic management.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1.

  • 2. WILBERT-LAMPEN U SELIGER C ZILKER T ARENDT RM. Cocaine Increases the Endothelial Release of Immunoreactive Endothelin and Its Concentrations in Human Plasma and Urine: Reversal by Coincubation With σ-Receptor Antagonists. Circulation 1998 98(5):385-390.

  • 3. MO W SINGH AK ARRUDA JAL DUNEA G. Role of Nitric Oxide in Cocaine-Induced Acute Hypertension. American Journal of Hypertension 1998 11(6):708-714.

  • 4. LANGE RA HILLIS LD. Cardiovascular Complications of Cocaine Use. New England Journal of Medicine 2001 345(5):351-358.

  • 5. HEESCH CM WILHELM CR RISTICH J ADNANE J BONTEMPO FA WAGNER WR. Cocaine activates platelets and increases the formation of circulating platelet containing microaggregates in humans. Heart 2000 83(6):688-695.

  • 6. RINDER HM AULT KA JATLOW PI KOSTEN TR SMITH BR. Platelet alpha-granule release in cocaine users. Circulation 1994 90(3):1162-1167.

  • 7. SIEGEL AJ MENDELSON JH SHOLAR MB MCDONALD JC LEWANDROWSKI KB LEWANDROWSKI EL LIPINSKA I RIDKER PM TOFLER GH. Effect of cocaine usage on C-reactive protein von Willebrand factor and fibrinogen. American Journal of Cardiology 89(9):1133-1135.

  • 8. SCHWARTZ BG REZKALLA S KLONER RA. Cardiovascular Effects of Cocaine. Circulation 2010 122(24):2558-2569.

  • 9. GUO J GANG H ZHANG S. Molecular Determinants of Cocaine Block of Human Ether-á-go-go-Related Gene Potassium Channels. Journal of Pharmacology and Experimental Therapeutics 2006 317(2):865-874.

  • 10. KARCH SB. The pathology of drug abuse. CRC Press Boca Raton; 1996.

  • 11. QURESHI AI SURI MFK GUTERMAN LR HOPKINS LN. Cocaine Use and the Likelihood of Nonfatal Myocardial Infarction and Stroke: Data From the Third National Health and Nutrition Examination Survey. Circulation 2001 103(4):502-506.

  • 12. HOLLANDER JE HOFFMAN RS. Cocaine-induced myocardial infarction: An analysis and review of the literature. Journal of Emergency Medicine 10(2):169-177.

  • 13. MOHAMAD T NIRAJ A FARAH J OBIDEEN M BADHEKA A KONDUR A THATAI D AFONSO L. Spectrum of electrocardiographic and angiographic coronary artery disease findings in patients with cocaine-associated myocardial infarction. Coronary artery disease 2009 20(5):332-336.

  • 14. HOLLANDER JE HOFFMAN RS BURSTEIN JL et al. Cocaine-associated myocardial infarction: Mortality and complications. Archives of Internal Medicine 1995 155(10):1081-1086.

  • 15. HSUE PY SALINAS CL BOLGER AF BENOWITZ NL WATERS DD. Acute Aortic Dissection Related to Crack Cocaine. Circulation 2002 105(13):1592-1595.

  • 16. DEAN JH WOZNICKI EM O'GARA P MONTGOMERY DG TRIMARCHI S MYRMEL T PYERITZ RE HARRIS KM SUZUKI T BRAVERMAN AC et al. Cocaine-related Aortic Dissection: Lessons from the International Registry of Acute Aortic Dissection. The American Journal of Medicine 127(9):878-885.

  • 17. EAGLE KA ISSELBACHER EM DESANCTIS RW INVESTIGATORS tIRfAD. Cocaine-Related Aortic Dissection in Perspective. Circulation 2002 105(13):1529-1530.

  • 18. CHAMBERS HF MORRIS DL TÄUBER MG MODIN G. Cocaine Use and the Risk for Endocarditis in Intravenous Drug Users. Annals of Internal Medicine 1987 106(6):833-836.

  • 19. BRECKLIN CS GOPANIUK-FOLGA A KRAVETZ T SABAH S SINGH A ARRUDA JAL DUNEA G. Prevalence of Hypertension in Chronic Cocaine Users. American Journal of Hypertension 1998 11(11):1279-1283.

  • 20. CATRAVAS JD WATERS IW. Acute cocaine intoxication in the conscious dog: studies on the mechanism of lethality. Journal of Pharmacology and Experimental Therapeutics 1981 217(2):350-356.

  • 21. BROGAN IIIWC LANGE RA KIM AS MOLITERNO DJ HILLIS LD. Alleviation of cocaine-induced coronary vasoconstriction by nitroglycerin. Journal of the American College of Cardiology 1991 18(2):581-586.

  • 22. SOFUOGLU M BROWN S BABB DA PENTEL PR HATSUKAMI DK. Carvedilol affects the physiological and behavioral response to smoked cocaine in humans. Drug & Alcohol Dependence 60(1):69-76.

  • 23. MARTIN-SCHILD S ALBRIGHT KC MISRA V PHILIP M BARRETO AD HALLEVI H GROTTA JC SAVITZ SI. Intravenous Tissue Plasminogen Activator in Patients with Cocaine-Associated Acute Ischemic Stroke. Stroke; a journal of cerebral circulation 2009 40(11):3635-3637.

  • 24. AFSHARI R MAXWELL SRJ WEBB DJ BATEMAN DN. Morphine is an arteriolar vasodilator in man. British Journal of Clinical Pharmacology 2009 67(4):386-393.

  • 25. LIU C DAI R YU R XU J. Morphine preconditioning cardioprotection and left ventricular remodelling in rabbits. Acta Cardiol 2011 66(3):341-348.

  • 26. TINTINALLI JE STAPCZYNSKI JS. Tintinalli's emergency medicine: a comprehensive study guide. McGraw-Hill New York; 2011.

  • 27. KOHRS R DURIEUX ME. Ketamine: Teaching an old drug new tricks. Anesthesia & Analgesia 1998 87(5):1186-1193.

  • 28. SPRUNG MDPJ SCHUETZ BSSHANNON M STEWART MDROBERT W MORAVEC PCHRISTINE S. Effects of ketamine on the contractility of failing and nonfailing human heart muscles in vitro. The Journal of the American Society of Anesthesiologists 1998 88(5):1202-1210.

Cited By
Gesamte Zeit Letztes Jahr Letzte 30 Tage
Abstract Views 0 0 0
Full Text Views 420 183 15
PDF Downloads 201 103 5