A person who uses cocaine chronically may develop a number of changes in the electrocardiogram (ECG).

Patient selection: chronic cocaine use


Wave changes in the ECG that can be seen include:

(1) increased QRS voltage

(2) abnormal precordial R wave progression

(3) nonspecific ST-T wave changes

(4) ST elevation


Other changes include:

(1) tachycardia (sinus, supraventricular)

(2) QTc > 440 ms

(3) Brugada type 2 phenocopy

(4) left ventricular hypertrophy

(5) signs of old myocardial infarction

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