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Lethal heart condition traced to cocaine use

DALLAS, March 12 Cocaine can cause a lethal tearing in the hearts main artery, a condition that should be suspected in people treated for chest pain at urban hospitals, say researchers in todays rapid access issue of Circulation: Journal of the American Heart Association. A preliminary report of the study was presented at the American Heart Associations annual Scientific Sessions last November.

The condition called aortic dissection occurs when the lining of the aorta the major blood vessel carrying blood from the heart tears, exposing the inner layer. Cocaine use is not a commonly recognized risk factor for aortic dissection, which usually occurs in older people with high blood pressure. However, researchers at San Francisco General Hospital noticed younger patients coming to the hospital with aortic dissection due to cocaine use.

Most patients came to the hospital with chest pain shortly after drug use, and one developed symptoms while smoking crack, says primary researcher Priscilla Y. Hsue, M.D., division of cardiology, San Francisco General Hospital.

Cocaine use causes an increase in stress hormones that can cause blood pressure to quickly rise. This may tear the lining of the vessel, which can allow blood to enter and rip it even further, says Hsue. The dissection may stop blood from reaching critical organs, or even cause the aorta to rupture.

In urban settings, aortic dissection should be considered when young people come to the emergency room with severe chest pain, especially if they have other risk factors like high blood pressure and smoking, says Hsue. Its very important to get a rapid diagnosis. For untreated aortic dissection, the mortality rate can be as high as 35 percent within the first 24 hours. After 48 hours the death rate rises to about 50 percent.

Researchers reviewed hospital charts from 1981-2001 looking for cases of aortic dissection. They recorded demographic information as well as information on
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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
11-Mar-2002


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