Coronary-Artery Vasoconstriction Induced by Cocaine, Cigarette Smoking, or Both

Over the past decade, cocaine abuse has become widespread, with over 30 million Americans estimated to have used it 1 . As its use has escalated, cocaine-associated catastrophic cardiac events, such as acute myocardial infarction and sudden death, have been reported occasionally. Although even small amounts of intranasal cocaine increase the metabolic requirement of the heart for oxygen and decrease the supply of oxygen, 2 the mechanisms whereby cocaine abuse sometimes causes cardiac catastrophes are poorly understood. Previous studies have shown that cigarette smoking also causes a slight increase in myocardial oxygen demand and a concomitant reduction in supply 3 – 8 . Other . . .