A considerable number of regular cocaine users have heart damage and do not know it, researchers revealed in the medical journal Heart. Serious heart damage among cocaine users commonly has no symptoms.
Cocaine is the most potent stimulant of natural origin. It is extracted from the coca scrub leaf, a plant indigenous to the Andes regions in South America. Cocaine is a bitter, addictive pain blocker (anesthetic). Its name came from the plant’s name (coca). Cocaine is often called coke. Illegal cocaine is usually sold as a white crystalline powder, or as an off-white chunky material. Dealers commonly adulterate cocaine in order to increase volume and make more money.
Cocaine can be snorted, injected and smoked (crack cocaine).
In western industrialized nations, cocaine is the most commonly used illegal drug. Health authorities estimate that there are approximately 6.4 million users in the USA.
About 1 in every 5 cocaine addicts has inflammation of the heart muscle (myocarditis), according to autopsy studies. Approximately one quarter of all non-fatal heart attacks among individuals aged 45 years or less are linked to cocaine usage, the authors wrote.
Myocarditis is associated with heart failure and chest pain. It can also trigger fatal and non-fatal heart attacks. However, in most cases the patient does not have the typical narrowed arteries that cause ischemic heart disease.
The authors wanted to determine whether there was any compelling evidence linking heart damage to long-term cocaine use, especially among people with no history of heart disease or heart problem symptoms.
They studied 30 long-term cocaine users who were involved in a residential drug rehabilitation program – 48 hours after they had last used cocaine. Their average age was 37. One in every five of them was also either HIV positive or was infected with hepatitis C.
Sixteen of them had also been taking other substances, such as heroin, opioids and alcohol (ethanol). They self-reported using about 5.5g of cocaine daily and had been using for an average of 12 years.
The majority of them said they snorted the drug. Ten injected it intravenously, while two smoked it.
They underwent a series of comprehensive tests to identify any abnormalities in heart structure and function. Tests included CMR (magnetic resonance imaging of the heart), exercise stress tests, and monitoring electrical activity over 24 hours (ECG).
In all cases heart function was found to be normal. However, localized abnormalities were detected in 12 of them. CMR identified structural damage in 83% of them.
In 47% of them the researchers detected edema in the left ventricle (lower left chamber of the heart). The more cocaine they regularly consumed, the more severe the edema was.
CMR detected fibrosis in 73% of participants – perhaps because of a silent heart attack or toxic damage, the authors wrote.
Fibrosis is not reversible, while edema is. Edema is an indicator of recent damage.
The scientists say that viral infection as well as multiple drug use could have contributed to heart damage. However, only two patients with a viral infection had myocardial damage.
Written by Christian Nordqvist