There are many ways that cocaine can kill you. Today we are going to be focusing on just one of the many ways by discussing a condition called acute aortic dissection (AD).
Take a close look at this heart of a follow up patient who suffered from an AD and also had a pre-existing case of coarctation of the aorta. In recent years, it has become increasingly clear that there is a relationship between cocaine use and acute aortic dissection. AD is a rare, potentially catastrophic vascular emergency where the inner layer of the aorta tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate or ‘dissect’. You may notice this separation at the top of this heart.
If the blood-filled channel ruptures through the outside aortic wall, AD is often fatal. Cocaine serves as both a predisposing factor to AD due to its effect on aortic connective tissue and as a precipitating factor due to its propensity to produce abrupt and severe hypertension. According to the National Library of Medicine, a retrospective chart review was performed of all hospital records during a 15-year period in patients diagnosed with AD. Among the 164 cases of acute AD, 16 patients (9.8%) had used cocaine or its derivative, crack cocaine, within twenty four hours prior to the onset of symptoms. The remaining 148 patients (90.2%) had no history of cocaine usage. Clinical features, management, and outcome in these two groups were also compared. It was found that patients in the cocaine group were younger in age and more likely to have a history of polysubstance abuse. Patients suffering from an acute AD typically present to the emergency department with severe, sharp, tearing chest pain that radiates to the back. The good news is: you can decrease your risk of ever suffering from this condition by staying away from cocaine!
Written by Student Doctor: Navpreet Singh Badesha ©07/05/2017 All Rights Reserved.
This research was published in the National Library of Medicine. (Article One) (Article Two)
