Cocaine-related aortic dissection in perspective
| Autor: | Roman W. DeSanctis, Eric M. Isselbacher, Kim A. Eagle |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
medicine.medical_specialty
Chest Pain Myocarditis Population Aortic Diseases Black People Dissection (medical) Risk Factors Physiology (medical) Internal medicine medicine.artery Medicine Humans Myocardial infarction education Aortic dissection Aorta education.field_of_study business.industry Irad medicine.disease Surgery Acute Disease Hypertension Cardiology Crack Cocaine Cardiology and Cardiovascular Medicine business Complication |
| Zdroj: | Circulation. 105(13) |
| ISSN: | 1524-4539 |
| Popis: | Cardiovascular complications of cocaine use have been ever more widely recognized and include the acceleration of atherosclerosis, coronary artery spasm, acute myocardial infarction, myocarditis, dilated cardiomyopathies, and cardiac arrhythmias. Less well known is the potentially lethal complication of aortic dissection. In the present issue of Circulation , Hsue and colleagues1 report on their 20-year experience with acute aortic dissection at an inner-city hospital. Remarkably, their findings indicate that 14 (37%) of 38 patients treated for acute dissection reported having used cocaine in the minutes or hours preceding their presentation. Cocaine, particularly crack cocaine, seemed to have played a significant role in precipitating aortic dissection among this cohort of young (age 41±8.8 years), predominantly black (11 of 14; 79%), and hypertensive (11 of 14; 79%) individuals. This study represents the largest cohort of cocaine-related dissection ever reported. Its findings provoke a number of questions for those of us who study or manage this rare but highly lethal condition. See p 1592 How common is cocaine-related aortic dissection? Previous reports predominantly have been descriptions of a single patient2 or a summary of individual case reports.3 The presumption has been that cocaine is a very rare cause of a very rare condition. The report by Hsue et al1 would seem to challenge that logic, but the authors freely admit that the inner-city population served by their hospital likely is responsible for this. In fact, because they accumulated only 14 patients over 20 years at their hospital, a cocaine-related dissection was encountered less than once per year. The International Registry for Aortic Dissection (IRAD) represents a unique effort by 17 aortic centers around the world to characterize the current status of acute aortic dissection, including its predisposing conditions.4,5⇓ We were able to work with IRAD’s coordinating center to … |
| Databáze: | OpenAIRE |
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