Early use of beta blockers in patients with cocaine associated chest pain
Autor: | Savi Mushiyev, Luciano J. Pastori, Gerald Pekler, Christian Espana Schmidt, Ferdinand Visco |
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Jazyk: | angličtina |
Rok vydání: | 2015 |
Předmět: |
Medical unit
lcsh:Diseases of the circulatory (Cardiovascular) system Cardiac & Cardiovascular Systems Beta blockers business.industry Cocaine induced chest pain Adrenergic Chest pain Article Blood pressure Cocaine lcsh:RC666-701 Anesthesia Heart rate medicine In patient medicine.symptom Cardiology and Cardiovascular Medicine business Cocaine abuse Unopposed alpha effect |
Zdroj: | International Journal of Cardiology: Heart & Vasculature, Vol 8, Iss C, Pp 167-169 (2015) International Journal of Cardiology. Heart & Vasculature Scipedia Open Access Scipedia SL |
ISSN: | 2352-9067 |
Popis: | Background The most common symptom of cocaine abuse is chest pain. Cocaine induced chest pain (CICP) shares patho-physiological pathways with the acute coronary syndromes (ACS). A key event is the increase of activity of the adrenergic system. Beta blockers (BBs), a cornerstone in the treatment of ACS, are felt to be contraindicated in the patient with CICP due to a potential of an “unopposed alpha adrenergic effect (UAE)”. Objectives Identify signs of UAE and in-hospital complications in patients who received BB while having cocaine induced chest pain. Methods We performed a retrospective review of 378 patients admitted to a medical unit because of CICP. Twenty six of these were given a BB at the time of admission while having CICP. We compared these patients to a control group paired by age, sex, race and history of hypertension who did not received a BB while having CICP. Blood pressure, heart rate, length of stay and in-hospital cardiovascular complications were compared. Results No statistically significant differences were found between the two groups except for a longer length of stay in the case group. This was felt to be due to unrelated causes. Conclusions This study does not support the presence of an UAE in patients with continuing CICP and treated early with BB. There were no in-hospital cardiovascular complications in the group of patients who had an early dose of BB while having CICP. Implications BB appeared safe when given early on admission to patients with CICP. |
Databáze: | OpenAIRE |
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