Chest
Volume 85, Issue 1, January 1984, Pages 132-133
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Asystole and Ventricular Fibrillation Associated with Cocaine Intoxication

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We discuss a patient with cocaine intoxication in whom the initial presentation was that of asystole and ventricular fibrillation. Cocaine has a direct toxic action on the heart and also sensitizes cardiac tissue to the action of catecholamines. Cocaine intoxication should be considered in any patient with unexplained cardiac arrest or ventricular arrhythmias.

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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)

  • HaddadLM

    Cocaine in perspective

    JACEP

    (1979)
  • FischmanMW et al.

    Cardiovascular and subjective effects of intravenous cocaine administration in humans

    Arch Gen Psychiatry

    (1976)
  • BenchimolA et al.

    Accelerated ventricular rhythm and cocaine abuse

    Ann Intern Med

    (1978)
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