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Taken Cocaine, Chest Pain, EKG And Blood Pressure Normal, No Sign Of Heart Attack. Any Advice?

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Posted on Sat, 14 Jul 2012
Question: Hello. I used a small amount of cocaine one week ago (4-6 bumps throughout the evening). I have only used cocaine a few times in my lifetime. The last, over 5 years ago. I have experienced chest pain since that night. I have been to the ER and doctor. Both EKG's were normal, blood pressure normal, as were the 2 blood tests at the hospital- no sign of heart attack. The pain in my chest is worrisome though. Any advice on what to do? Please advise
doctor
Answered by Dr. Pavan Kumar Gupta (1 hour later)
Hello XXXXXXX
Thanks for the query.
Cocaine causes tachycardia and increased oxygen demand a situation that is exacerbated when alcohol is taken at the same time. It also causes vasoconstriction, including constriction of the coronary arteries. This occurs even when only small doses are taken ( for example, via the nasal route).

 People using Cocaine usually develop chest pain around 3 hours after using. The pain is often atypical in character and duration although it may be described as a pressure like in quality, and it can be accompanied by anxiety, palpitations, nausea and shortness of breath.
Symptoms may persist for up to 4 days after use.

Since you already have gone to ER,at least heart involvement is ruled out.
Other common non cardiac causes for chest pain are
Gastric reasons like gastroesophageal reflux disease(GERD) and gastritis
Muscular reasons like costochondritis
Lung causes like pneumonia
But all these problems have other attendant problems which can help in the diagnosis.
However I would advise you to relax and wait for 4 to 5 days more
I have a feeling that your problem may go away of it's own
However if the problem still persist for more than a week a revisit to your doctor will be required.
In the mean time take some antacids like pantoprozole 40 mg daily in morning empty stomach for a week if you feel acidity or bloating.
Do local hot fomentation
You may add some some anti inflammatory like ibuprofen 400 mg three times a day if there is no hyperacidity.
I hope to have answered your query however you may revert to me for any further query
Best of luck.
Thanks

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Pavan Kumar Gupta (30 hours later)
Thank you, Dr.
The pain seems to come and go lately. I have been trying to relax. I am also taking some lorezepam .5mg - 1mg. but might switch to clonezepam. I will also see the acupuncturist . I have zegerid otc (omerpazole, 20mg) and rantidine 300mg in my med closet. Which do you recommend I take. ? Like I said, I went to the ER and doctor , 2 ekgs- normal, along with bp and pulse. On the safe side, my cardiologist said to come in for a stress test on Monday but I don't think that will show anything. The pain has become more of a burning isolated one at times. and when i think about it, it magnifies (thus taking the lorezepam/clon) Any other suggestions? Is it safe to exercise?
I will try the hot formentation and see if that helps
will steam shower help as well? thank you
doctor
Answered by Dr. Pavan Kumar Gupta (35 minutes later)
Hello
I would advise you to take omeprazole 20 mg twice a day half hour before meals.
There is no harm in getting the stress test done as advised by your doctor at the ER.
You seem to have some anxiety levels in you which may be magnifying your symptoms.
Avoid exercises till you get a stress test done and get a clearance from the doctor.
You may do hot fomentation but I doubt steam shower would help.
Try to de stress yourself and adopt some XXXXXXX breathing relaxation techniques.
I hope you shall be alright soon.
Thanks
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Pavan Kumar Gupta (10 minutes later)
Thank you ffor your quick response.
So you do think problems like these can be magnified by anxiety? If all the cardio tests come out negative, i should not be concerned that i have any severe illness, heart or otherwise related? which could have been brought on by the cocaine use?
doctor
Answered by Dr. Pavan Kumar Gupta (26 minutes later)
Hello
If all the cardiac tests turn out to be negative,it clearly indicates that you don't have any serious illness.
Anxiety can definitely magnify your problems.
Thanks
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Pavan Kumar Gupta

General & Family Physician

Practicing since :1978

Answered : 6704 Questions

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Taken Cocaine, Chest Pain, EKG And Blood Pressure Normal, No Sign Of Heart Attack. Any Advice?

Hello XXXXXXX
Thanks for the query.
Cocaine causes tachycardia and increased oxygen demand a situation that is exacerbated when alcohol is taken at the same time. It also causes vasoconstriction, including constriction of the coronary arteries. This occurs even when only small doses are taken ( for example, via the nasal route).

 People using Cocaine usually develop chest pain around 3 hours after using. The pain is often atypical in character and duration although it may be described as a pressure like in quality, and it can be accompanied by anxiety, palpitations, nausea and shortness of breath.
Symptoms may persist for up to 4 days after use.

Since you already have gone to ER,at least heart involvement is ruled out.
Other common non cardiac causes for chest pain are
Gastric reasons like gastroesophageal reflux disease(GERD) and gastritis
Muscular reasons like costochondritis
Lung causes like pneumonia
But all these problems have other attendant problems which can help in the diagnosis.
However I would advise you to relax and wait for 4 to 5 days more
I have a feeling that your problem may go away of it's own
However if the problem still persist for more than a week a revisit to your doctor will be required.
In the mean time take some antacids like pantoprozole 40 mg daily in morning empty stomach for a week if you feel acidity or bloating.
Do local hot fomentation
You may add some some anti inflammatory like ibuprofen 400 mg three times a day if there is no hyperacidity.
I hope to have answered your query however you may revert to me for any further query
Best of luck.
Thanks