Cocaine and Chest Pain
Authors: Mahesh Amin, Gary Gabelman
Journal: Annals of Internal Medicine (1992)

Letters1 January 1992Cocaine and Chest PainMahesh Amin, MD, Gary Gabelman, MDMahesh Amin, MD, Gary Gabelman, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-116-1-91 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editors:The article by Gitter and colleagues (1) presents findings similar to those from our own study (2). The authors, however, have placed undue importance on the 0% myocardial infarction rate in their cohort of patients hospitalized for chest pain after cocaine use. Their retrospective analysis has many inherent problems (as they acknowledge)—for example, incomplete electrocardiographic (ECG) data (41%) and the lack of serial creatine kinase-MB fraction measurements (9%). Because criteria for the diagnosis of acute myocardial infarction include a typical history, serial ECG changes, and an elevated creatine kinase-MB fraction, some of their patients may indeed have...References1. GitterGoldsmithDunbarSharkey MSDS. Cocaine and chest pain: clinical features and outcome of patients hospitalized to rule out myocardial infarction. Ann Intern Med. 1991;115:277-82. LinkGoogle Scholar2. AminGabelmanKarpelButtrick MGJP. Acute myocardial infarction and chest pain syndromes after cocaine use. Am J Cardiol. 1990;66:1434-7. CrossrefMedlineGoogle Scholar3. PasternakBraunwaldSobel REB. Acute myocardial infarction. In: Braunwald E, ed. Heart Disease. Third edition. Philadelphia: W.B. Saunders Co.; 1988:1222-313. Google Scholar1. GitterGoldsmithDunbarSharkey MSDS. Cocaine and chest pain: clinical features and outcome of patients hospitalized to rule out myocardial infarction. Ann Intern Med. 1991;115:277-82. LinkGoogle Scholar2. ZimmermanDellingerMajid JRP. Cocaine-associated chest pain. Ann Emerg Med. 1991;20:611-5. CrossrefMedlineGoogle Scholar3. Cheng T. Cardiovascular complications. In: Pradhan SN, Dutta SN, eds. Drug Abuse: Clinical and Basic Aspects. St. Louis: C.V. Mosby; 1977:388-99. Google Scholar1. GitterGoldsmithDunbarSharkey MSDS. Cocaine and chest pain: clinical features and outcome of patients hospitalized to rule out myocardial infarction. Ann Intern Med. 1991;115:277-82. LinkGoogle Scholar2. ParisiBeckmanLancaster ACM. The spectrum of ST-segment elevation in the electrocardiograms of healthy adult men. J Electrocardiol. 1971;4:137-44. CrossrefMedlineGoogle Scholar3. WasserburgerAltLloyd RWC. The normal RS-T segment elevation variant. Am J Cardiol. 1961;7:184-92. CrossrefGoogle Scholar4. WienerRiosMassum LJR. T-wave inversion with elevated RS-T segment simulating myocardial injury. Am Heart J. 1964;67:684-8. CrossrefMedlineGoogle Scholar5. Goldberger A. Myocardial Infarction: Electrocardiographic Differential Diagnosis. St. Louis: C.V. Mosby Co.; 1984:242-5. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Mahesh Amin, MD; Gary Gabelman, MDAffiliations: Montefiore Medical Center Bronx, NY 10467 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe Case for Community Hospital AngioplastyManagement of cocaine-induced cardiovascular complicationsThe Clinical Manifestions of Cocaine Abuse 1 January 1992Volume 116, Issue 1Page: 91-92KeywordsAcute myocardial infarctionCocaineCreatineElectrocardiographyIschemiaMyocardial infarction ePublished: 1 December 2008 Issue Published: 1 January 1992 PDF downloadLoading ...