Review outlines cardiovascular risks and care pathways for stimulant drug use

A narrative review searched PubMed through March 2024 to summarize acute cardiovascular complications linked to sympathomimetic recreational drugs including cocaine, amphetamine-type stimulants, and synthetic cathinones. The review reports that these substances cause catecholamine excess, vasospasm, thrombosis, and direct myocardial toxicity, producing chest pain, acute coronary syndrome, arrhythmias, cardiomyopathy, and sudden cardiac death, with presentations sometimes more severe than classical cardiac syndromes, particularly in younger patients lacking traditional risk factors. The authors state that evaluation should generally follow standard guideline-based cardiovascular care with modifications such as selective toxicological testing, early sedation, and cautious beta-blocker selection depending on the substance involved.

Most relevant for: Emergency department and acute care clinicians evaluating young patients presenting with chest pain, arrhythmia, or suspected cardiac events related to recreational stimulant use.

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