Cocaine is the second most used illicit drug after Marijuana and has significant detrimental health effects, many of which involve the heart. The cardiac effects of cocaine range from high blood pressure to the more severe heart failure and heart attacks.
Cocaine has many effects on the blood vessels and blood components, which include the platelets. When one ingests cocaine, one of the major responses of cocaine is its vasoconstrictor effect on the blood vessels, which means that it will cause the blood vessels throughout the body to clamp down, which will not only increase the blood pressure, but over time, will cause the heart to have to work harder to pump the same amount of blood to the body. Eventually, if one is a chronic cocaine user, the heart will begin to tire out and become fatigued because the heart can not sustain that workload for such a prolonged period of time. At times, this heart failure may or may not be reversible with medications. If the heart fails and leads to heart failure, the person may begin to have blood and fluid buildup in the lungs, which will cause the person to feel short of breath and weak. He or she may have problems lying flat or sleeping as blood tends to drain more towards the heart and lungs in a supine position, which will make the shortness worsen. These heart failure patients may need to be treated with “water pills” (diuretics), which will make one urinate more often, however, these medications only treat the symptoms, not the ultimate problem of the failure heart. The ultimate solution is cessation of all cocaine products, blood pressure control and other medications such as beta blockers and angiotensin converting enzyme inhibitors. The latter 2 drugs help to “remodel” the heart and potentially improve the function. If medical therapy does not work, these individuals with heart failure are at risk for sudden cardiac death, which can only be prevented by inserting an implantable defribillator, which will “shock” them out an abnormal heart beat (very similar to what is seen on TV shows such as ER and Grey’s Anatomy).
Cocaine’s effects on the blood components such as platelets is very significant and provoke increased clotting and platelet dysfunction, which will cause the body to form clots and may plaque rupture in the arteries surrounding the heart or even a stroke in the brain. It may even increase the risk of blood clots in the legs, which could travel to the heart and cause a pulmonary embolism (clot in the lungs).
In conclusion, cocaine has very serious effects on the heart by increasing the blood pressure, which may eventually lead to heart failure and sudden cardiac death if not treated appropriately. Cocaine is known to induce heart attacks through many mechanisms, which include its effects on blood vessels as well as platelets.