Cocaine use and acute myocardial infarction

Cocaine-associated chest pain is a commonly encountered emergency. This article reviews the pathology and describes a management plan that will allow emergency physicians to provide appropriate care to patients with cocaine-associated chest pain. A combination of clinical criteria with a 12-hour observation period can be used to identify most patients at risk for complications. For the majority of patients with cocaine-associated pain, however, a plan consisting of outpatient evaluation with dynamic testing and cocaine detoxification will usually suffice.