Cocaine induced heart failure: report and literature review.
Level 4 - case-series / case-control
Single patient case report combined with a narrative review.
PubMed 34211666 · doi:10.1080/20009666.2021.1926614
What was done
This paper describes a case report of a 43-year-old male with a history of long-standing cocaine use presenting with acute decompensated heart failure, accompanied by a narrative review of the mechanisms and treatment of cocaine-induced cardiotoxicity.
What was found
The patient was admitted to the intensive care unit with cardiomyopathy and a left ventricular ejection fraction of <20%. He required invasive mechanical ventilation and inotropic support with milrinone before being extubated and discharged for outpatient cardiac transplantation evaluation.
Why it matters
It illustrates the severe presentation of cocaine-induced cardiomyopathy and outlines management strategies, including the controversy regarding beta-blocker use due to potential unopposed alpha-adrenergic stimulation.
Limits
Findings are limited to a single uncontrolled case report and a non-systematic narrative literature review; it cannot establish causation, prevalence, or comparative treatment efficacy.
Cited by
- supports Stimulant use, particularly cocaine, is associated with a high incidence of heart failure and premature cardiac death.