Coronary-Artery Spasm and Myocardial Infarction Associated with Cocaine Use

To the Editor: Cocaine blocks the uptake of endogenously secreted catecholamines 1 and has been associated with ventricular arrhythmia 2 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 . . .