Cesar Del Aguila, MD; Howard Rosman, MD
To the Editor: Nademanee and colleagues (1) demonstrated ST segment changes of silent ischemia during Holter monitoring in 8 of 21 chronic cocaine abusers who had stopped taking the drug an average of 8.5 days before testing. These patients had normal exercise treadmill tests and were presumed free of significant coronary atherosclerosis. The authors of this interesting study proposed the dopamine depletion hypothesis to explain the coronary vasoconstriction (spasm) observed in these subjects. We report a case of myocardial infarction during cocaine withdrawal and postulate an alternative hypothesis to explain this phenomenon.
A 42-year-old male chronic cocaine (crack) smoker was
Del Aguila C, Rosman H. Myocardial Infarction during Cocaine Withdrawal. Ann Intern Med. 1990;112:712. doi: 10.7326/0003-4819-112-9-712_1
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Published: Ann Intern Med. 1990;112(9):712.
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