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The role of illicit drug use in sudden death in the young

Published online by Cambridge University Press:  13 January 2017

Peter Fischbach
Peter Fischbach*
Affiliation:
Children’s Pediatric Cardiology Fellowship Program, Sibley Heart Center Cardiology and Emory University, Atlanta, Georgia, United States of America
*
Correspondence to: P. Fischbach, Chief Academic Officer, Children’s Pediatric Cardiology Fellowship Program, Sibley Heart Center Cardiology and Emory University, 1405 Clifton Road NE, Atlanta, GA 30322, United States of America. Tel: 404 256 2593; Fax: 678 547 1494; E-mail: fischbachp@kidsheart.com
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Abstract

The recreational use of illicit drugs remains an enormous and growing problem throughout the United States of America and around the world. Cocaine is most frequently thought of when considering the cardiovascular toxicity of illicit drugs. The association of cocaine use with sudden death due to myocardial ischaemia and infarction is well recognised, and this risk appears to be amplified by concomitant cigarette smoking and alcohol consumption. Like cocaine, amphetamine and its derivatives lead to indirect stimulation of the autonomic nervous system through the release of norepinephrine, dopamine, and serotonin in nerve terminals of the central and autonomic nervous systems. However, amphetamine lacks the ion channel-blocking properties of cocaine. Also similar to cocaine, coronary artery spasm may be induced in individuals with or without atherosclerotic disease and may lead to myocardial infarction. With the movement across the United States of America to legalise marijuana, or cannabis, for medicinal and recreational purposes, it is important to consider its potential deleterious effects. Marijuana has long been thought to have very few adverse effects with the exception of long-term dependence. There are, however, scattered reports of acute adverse events up to and including sudden death. These appear to be due to myocardial infarction. In conclusion, the incidence of sudden death associated with the use of these drugs varies from rare in the case of marijuana use to not infrequent with some drugs such as cocaine. It is important for care providers to recognise the potential for drug abuse when caring for a sudden cardiac arrest survivor.

Keywords

Recreational drug usecocaineamphetamineheroinsudden cardiac death
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Supplement S1: Sudden Cardiac Arrest in the Young: A Contemporary Perspective , January 2017 , pp. S75 - S79
Copyright
© Cambridge University Press 2017 

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