Cocaine Abuse: Repolarization Abnormalities and Ventricular Arrhythmias

Increased QT and QT dispersion has been linked to arrhythmic death in patients with congenital and acquired long QT syndromes. The repolarization abnormalities were studied in 45 patients with a history of chest pain, somnolence, or disorientation admitted to the hospital for cocaine abuse. Group I...

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Bibliographic Details
Published in:The American journal of the medical sciences 2000-07, Vol.320 (1), p.9-12
Main Authors: Gamouras, George A., Monir, George, Plunkitt, Kenneth, Gursoy, Sinan, Dreifus, Leonard S.
Format: Article
Language:English
Subjects:
Adult
Arrhythmias, Cardiac - etiology
Biological and medical sciences
Cocaine abuse
Cocaine-Related Disorders - complications
Cocaine-Related Disorders - physiopathology
Drug addictions
Electrocardiography
Female
Humans
Male
Medical sciences
Middle Aged
QTc
QTc dispersion
Toxicology
Ventricular arrhythmias
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Summary:Increased QT and QT dispersion has been linked to arrhythmic death in patients with congenital and acquired long QT syndromes. The repolarization abnormalities were studied in 45 patients with a history of chest pain, somnolence, or disorientation admitted to the hospital for cocaine abuse. Group I was composed of patients with anginal chest pain (n = 23), whereas in group II patients (n = 22), chest pain was absent. Measurements were made of QT and QTc and of QT and QTc dispersion characteristics. Cocaine prolonged the QT, QTc, and QTc dispersion and enhanced the appearance of abnormal U waves. Lethal ventricular arrhythmias were observed in 3 patients. Anginal chest pain may be a marker for myocardial ischemia and, in the presence of abnormal ventricular repolarization, may cause lethal ventricular arrhythmias and sudden death in persons exposed to cocaine.
ISSN:0002-9629
1538-2990
DOI:10.1016/S0002-9629(15)40791-8