1/4. cocaine induced myocardial infarction.The case of a 29 year old man who presented with chest pains after the use of cocaine is reported. The diagnosis of myocardial infarction was made on the electrocardiogram changes and lactate dehydrogenase profile. The diagnosis may be overlooked if there is no direct questioning about the use of drugs such as cocaine. diazepam has an important role in the management of cardiac complications after cocaine use and should be used early in management. The use of thrombolysis should be a joint decision between the emergency physician and cardiologist.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/4. cluster headache and cocaine use.We present 3 patients who had episodes of orofacial pain compatible with cluster headache, the differential diagnosis being established with pulp pain of dental origin. cocaine inhalation triggered pain in the premolar zone of the upper jaw, followed by spread of pain to the periorbital region on the same side. The pain episodes were very intense and lasted between 30 and 120 minutes. The patients presented conjunctival injection and lacrimation of the affected eye during these episodes. The crises were always unilateral. In one patient, pain shifted sides from one crisis to another within the same symptomatic or cluster period, affecting the side through which the drug was inhaled. pain usually appeared 1 to 2 hours after cocaine consumption, though it disappeared 5 to 10 minutes after again inhaling the drug. None of our patients acknowledged cocaine consumption at the first visit; drug inhalation was only admitted at subsequent visits, once a degree of confidence had been established with the physician.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/4. Midfacial osteomyelitis in a chronic cocaine abuser: a case report.We describe the case of a 56-year-old man who was admitted for treatment of a progressive destruction of his hard palate, septum, nasal cartilage, and soft palate that had been caused by chronic cocaine inhalation. biopsy of the bony septum revealed acute osteomyelitis and an extensive overgrowth of bacteria and actinomyces-like organisms. There was no evidence of granuloma or neoplasm. The patient received intravenous ampicillin/sulbactam for 6 weeks, followed by lifetime oral amoxicillin. When there was no further evidence that destruction was progressing, the patient underwent nasal reconstruction with a cranial bone graft. The surgery was completed with no complications. To our knowledge, this is the first reported case of midfacial osteomyelitis associated with chronic cocaine abuse. The severity of this patient's complications, coupled with the success of his reconstructive surgery, makes this case particularly interesting. We believe that it is important for physicians to understand that septal perforation in a cocaine abuser should not be underestimated because it could result in a secondary bone infection. Nasoseptal destruction secondary to intranasal cocaine abuse is a result of cocaine's vasoconstrictive properties, and a decrease in the oxygen tension of intranasal tissue can facilitate the growth of anaerobic pathogens.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/4. Fatal case of delayed repolarization due to cocaine abuse and global ischemia.When a previously healthy, middle-aged patient presents with apparent seizures, what should alert the physician to the possibility of underlying cardiac disease? This report describes a case of long qt syndrome, initially presenting as seizures, which expressed itself at an atypically advanced age as a result of cocaine use, global myocardial ischemia, and ventricular tachycardia.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |