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Cocaine-related emergency department visits increased by 47 percent from 1999 to 2002.

According to a recent announcement from the American Heart Association, when treating a patient with chest pain who has no obvious risks of heart disease, ER doctors should ask if the patient has used the street drug cocaine.

Most cocaine-associated chest pain is not a heart attack. Thus, it is recommended that these patients be monitored in an observation unit for 9 to 12 hours.

Studies indicate that chest pain related to cocaine use tends to show up within three hours of using the drug. But the chemical remnants of cocaine remain in the system for at least 18 hours and can continue to cause problems.

Cocaine increases the hearts need for oxygen by driving up heart rate, elevating blood pressure and increasing the hearts contraction (squeezing power) with each beat. At the same time, cocaine deprives the heart of oxygen by constricting the blood vessels and making the blood more likely to clot and cause a heart attack. The chest pain, called angina, is a symptom of the heart being starved for oxygen.

Other symptoms reported by patients with cocaine-related chest pain include shortness of breath, anxiety, palpitations, dizziness, nausea and profuse sweating. All of those are also symptoms of a heart attack.

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