Cocaine-Associated Dilated Cardiomyopathy

 

Features of cocaine-associated dilated cardiomyopathy:

(1) Some patients may have evidence of a myocarditis.

(2) Left ventricular hypertrophy occurs early, with ventricular dilatation developing as the disease progresses.

(3) In the typical case there is an absence of significant coronary artery disease. However, patients who have abused cocaine may have clinical evidence of myocardial ischemia despite normal-appearing coronary arteries.

 

Complications:

(1) stroke, which may be recurrent

(2) heart failure

 

Additional kinds of cardiac disease that can occur in patients who abuse cocaine:

(1) coronary artery disease with acute myocardial infarction and the potential for ischemic cardiomyopathy

(2) cardiac arrhythmias

(3) left ventricular apical ballooning (takotsubo cardiomyopathy)

(4) sudden death

(5) aortic dissection

(6) infectious endocarditis (especially in injecting drug users)

(7) alcohol-associated cardiomyopathy