Coronary-Artery Spasm and Myocardial Infarction Associated with Cocaine Use

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Abstract
To the Editor: Cocaine blocks the uptake of endogenously secreted catecholamines1 and has been associated with ventricular arrhythmia2 and sudden death.3 It may also cause myocardial infarction through coronary-artery vasoconstriction, but a previously reported myocardial infarction associated with cocaine use occurred in a man known to have coronary-artery disease.4 We recently cared for a 21-year-old man with structurally normal coronary arteries who had a myocardial infarction after recreational use of cocaine. This case raises the possibility that cocaine can cause coronary-artery spasm and myocardial infarction.The patient had no family history of premature coronary-artery disease, cigarette smoking, or other risk . . .

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