cocaine powerfully constricts blood vessels. This leads to a massive rise in blood pressure soon after the drug is taken, with a risk of stroke. Constriction of the coronary vessels can cause chest pain and heart attack.
one study has shown that the risk of a heart attack is 23-fold increased in the hour following cocaine use (2)
in long term users, these surges in blood pressure lead to a build up of atheroma, so that a regular cocaine user as young as 25-30 years without any other risk factor can develop triple vessel coronary artery disease as a result of cocaine use. Reports from the United States suggest that as many as one in four myocardial infarctions in people aged 18-45 are linked to cocaine use (3)
dissection of the aorta has also been reported in cocaine users
cocaine use can lead to arrhythmias - risk of arrythmias increases greatly during binges, but reduces again during periods of low use/abstinence (4)
cocaethylene, formed by combination of cocaine and alcohol increases the risk of cardiac problems
bacterial or viral endocarditis can result from injecting
DVT, more common than in heroin injectors
Reference:
(1) British Heart Foundation (6/2003). Factfile - Illicit drugs and the Heart.
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