A cocaine user with chest pain may fail to produce angiogram results that clearly indicate a need for further medical care, a new study has found.
It’s well known that people who use the stimulant street drug cocaine have substantially increased short- and long-term risks for a range of serious and potentially fatal problems in their cardiovascular (heart and blood vessel) systems. Doctors can use a procedure called an angiogram to detect serious malfunctions in the blood vessels connected to the heart. However, according to the results of a study presented to the American Heart Association in November 2014 by researchers from Chicago’s Mount Sinai Hospital, cocaine users can undergo potentially serious changes in their small, heart-related blood vessels that fail to register clearly on an angiogram.
Cocaine and Cardiovascular Health
Like amphetamine, methamphetamine and other stimulant drugs, cocaine produces a significant increase in the speed of activity inside the human central nervous system (brain and spinal cord). One of the consequences of this speedup is alteration of the normal function of the heart and blood vessels; specifically, cocaine can seriously increase the heart rate and produce a narrowing of the blood vessels that leads to spikes in blood pressure levels. The strain of repeated cocaine exposure (or, in some cases, even isolated episodes of cocaine use) can contribute to the onset of a range of short- and long-term cardiovascular complications, including chest pain (angina), strokes, heart attacks, insufficient heart function (i.e. heart failure), heart muscle inflammation, heart enlargement, blood vessel clots and tearing in the body’s main artery, called the aorta.
While some of the cardiovascular complications of cocaine affected only habitual users, first-time and occasional users of the drug also have a substantial chance of experiencing serious and potentially fatal changes in their heart and/or blood vessel health. Populations with particularly high risks include individuals with pre-existing problems in their coronary (heart-related) arteries and individuals with pre-existing problems in the arteries that carry blood to the brain.
An angiogram is a procedure that uses a combination of dye injection and X-rays to detect abnormalities in the vessels that feed oxygen-rich blood to the heart. During the procedure, a technician injects a dye that circulates to these blood vessels; this dye is detected by an X-ray machine, which produces images that provide an in-depth perspective on the blood vessels’ structural and functional health. Doctors typically recommend angiograms for people with angina or other indications of damaged coronary arteries, people with heart failure, people with known heart defects, people with accident-related chest damage and people with unexplained pain in parts of the body that include the upper torso, jaw and upper extremities.
Undetected Cocaine-Related Damage
In the study presented to the American Heart Association, the Mount Sinai Hospital researchers used the angiogram results of 412 adults to help determine if cocaine users can undergo potentially dangerous changes in blood vessel health that fail to show up on an angiogram. Two hundred two of the adults participating in the study were cocaine consumers, while the remaining 210 participants did not use the drug. Angiograms for both groups were collected between the years 2005 and 2013. The doctors compared the test results for the cocaine consumers and non-consumers.
After completing their comparison, the researchers concluded that many of the cocaine users had angiogram results that initially seemed more or less identical to the results found in the non-cocaine users. However, upon further inspection, they also concluded that the dye used for angiograms passed through the tiny blood vessels of the cocaine users more slowly than it passed through the tiny blood vessels of the non-users. The dye also produced an unusual widening of the cocaine users’ tiny blood vessels. These differences, while not recorded in the final results of an angiogram, indicate that cocaine consumers may nevertheless undergo changes in blood vessel health that contribute to the onset of shortness of breath, angina and other symptoms of potentially serious cardiovascular disease.
The study’s authors note that the changes in blood flow found in the cocaine-using participants’ smallest blood vessels were greater than the changes associated with such known predictors of cardiovascular problems as hypertension and diabetes in the non-cocaine users. They believe that a cocaine user may fail to produce angiogram results that indicate a need for further medical assistance. In some cases, a lack of such assistance may lead to more severe cardiovascular problems or even to fatal outcomes for affected cocaine consumers.