ABSTRACT
Increased QT and QT dispersion has been linked to arrhythmic death in patients with congenital and acquired long QT syndromes. The repolarization abnormalities were studied in 45 patients with a history of chest pain, somnolence, or disorientation admitted to the hospital for cocaine abuse. Group I was composed of patients with anginal chest pain (n = 23), whereas in group II patients (n = 22), chest pain was absent. Measurements were made of QT and QTc and of QT and QTc dispersion characteristics. Cocaine prolonged the QT, QTc, and QTc dispersion and enhanced the appearance of abnormal U waves. Lethal ventricular arrhythmias were observed in 3 patients. Anginal chest pain may be a marker for myocardial ischemia and, in the presence of abnormal ventricular repolarization, may cause lethal ventricular arrhythmias and sudden death in persons exposed to cocaine.
Subject(s)
Arrhythmias, Cardiac/etiology , Cocaine-Related Disorders/complications , Electrocardiography , Adult , Cocaine-Related Disorders/physiopathology , Female , Humans , Male , Middle AgedSubject(s)
Dyspnea/etiology , Edema/etiology , Pericarditis, Constrictive/diagnosis , Postoperative Complications , Diagnosis, Differential , Echocardiography, Transesophageal , Heart Septal Defects, Atrial/surgery , Humans , Male , Middle Aged , Pericarditis, Constrictive/complications , Postoperative Complications/diagnosis , Postoperative Complications/etiologySubject(s)
Anti-Bacterial Agents/therapeutic use , Endocarditis, Bacterial/drug therapy , Staphylococcal Infections/drug therapy , Staphylococcus epidermidis/drug effects , Virginiamycin/therapeutic use , Adult , Anti-Bacterial Agents/administration & dosage , Endocarditis, Bacterial/microbiology , Humans , Male , Methicillin Resistance , Staphylococcal Infections/microbiology , Vancomycin/adverse effects , Virginiamycin/administration & dosageABSTRACT
A 56-year old man was admitted to the hospital with malaise, weakness, and fatigue. He was short of breath and had bilateral foot edema. Even though he had been very active a month earlier, he could no longer climb stairs. For the last two weeks, he had had a cough producing green sputum, a "tight feeling" in his chest, polyuria, and polydipsia. He had not had radiating chest pain, palpitations, leg pain or erythema, hemoptysis, diaphoresis, flushing, fever, chills, nausea, vomiting, diarrhea, or a loud snore.
