Chest
Asystole and Ventricular Fibrillation Associated with Cocaine Intoxication
Section snippets
CASE REPORT
A 23-year-old woman was brought to the emergency room in a comatose state. She was found unconscious at her home by a friend. An empty syringe and spoon containing cocaine were found next to her. The paramedical staff could not record her blood pressure and the ECG showed asystole. Sodium bicarbonate, epinephrine and atropine were administered. This produced ventricular fibrillation. On arrival in the emergency room, she was intubated. She was subsequently transferred to the ICU. Her heart rate
DISCUSSION
With lethal doses of cocaine, the presenting picture is one of hyperthermia, status epilepticus ventricular arrhythmias and/or respiratory arrest.4 The reason for the occurrence of asystole and ventricular arrhythmias in the above patient was probably related to: a) direct toxic effect of cocaine on the heart, and b) the permissive role of cocaine in accentuating the influence of epinephrine and norepinephrine on cardiac tissue.5
While the oral lethal dose of cocaine is given as over 1 gram,
REFERENCES (6)
Cocaine in perspective
JACEP
(1979)- et al.
Cardiovascular and subjective effects of intravenous cocaine administration in humans
Arch Gen Psychiatry
(1976) - et al.
Accelerated ventricular rhythm and cocaine abuse
Ann Intern Med
(1978)