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Heart 2003;89:582-584; doi:10.1136/heart.89.5.582
Copyright © 2003 BMJ Publishing Group Ltd & British Cardiovascular Society
Heart 2003;89:582-584
© 2003 by BMJ Publishing Group & British Cardiac Society

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Iqbal Malik, Editor

The first 150 words of the full text of this article appear below.


Ischaemic heart disease

Only about 6% of episodes of cocaine induced chest pain are caused by MI {blacktriangleright}

Chest pain may be caused by ischaemia without infarction, or it may be extracardiac (for example, pleuritic) in nature. Weber and associates report on a prospective study in which they validated the hypothesis that such an approach is safe. They evaluated 344 patients with cocaine related chest discomfort. Forty two of these patients (12%) were admitted to the hospital with acute myocardial infarction (MI), unstable angina, or another cardiac condition. Among the remaining 302 patients, those who had no new electrocardiographic changes indicative of ischaemia, as well as normal concentrations of cardiac troponin I, a negative exercise test, and no cardiovascular complications during a 9–12 hour period in an observation unit, were discharged. Thirty day follow up in this cohort revealed that none of the patients died of a cardiovascular event. Four patients sustained a non-fatal MI; however, these patients had continued to use cocaine. So, many patients can be . . . [Full text of this article]


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