Honesty is the best policy
According to recent statements from the American Heart Association, younger patients experiencing chest pain similar to that associated with a heart attack need to be completely honest with their ER physicians. According to Dr. James McCord, “The symptoms that they get with the cocaine are very similar to a heart attack.” While cocaine use can cause a heart attack, it more often can cause the duplication of heart attack symptoms such as dizziness, sweating, chest pain, anxiety, palpitations, nausea, and the like. In light of the similarity of indicators, it creates an issue when physicians diagnose patients based solely on symptoms and not on complete disclosure from the patient.
The fact is that not disclosing cocaine use during emergency treatment can result in death. Some of the treatments for heart attack can be deadly to persons using cocaine. According to Dr. James Reiffel, professor of clinical medicine at Columbia University, “Not knowing what you are dealing with and giving the wrong therapies could mean death rather than benefit.” The following is an excerpt of an article from the AP that reviews the American Heart Association’s recommendations:
The number of cocaine-related users visiting ERs rose 47 percent from 1995 to 2002, increasing from 135,711 to 199,198, according to the government’s Substance Abuse and Mental Health Services Administration. (That’s a tiny percentage of the more than 100 million patient visits to emergency rooms each year.)
“The symptoms that they get with the cocaine are very similar to a heart attack,” said Dr. James McCord, who chaired the statement writing committee.
Cocaine can cause a heart attack, but only about 1 percent to 6 percent of patients with cocaine-associated chest pain actually have a heart attack, the statement says. Still, doctors say it’s important for anyone with chest pain to get it checked out.
Cocaine increases blood pressure and the heart rate, constricting arteries into the heart, said McCord, cardiology director of the chest pain unit for the Henry Ford Health System in Detroit.
“Your heart rate goes up because your heart needs more oxygen, then it shrinks the arteries to the heart,” McCord said.
The statement says that since most cocaine-associated chest pain isn’t a heart attack, such patients should be monitored instead of being admitted to the hospital. They would have an electrocardiogram and other tests to rule out a heart attack.