RESUMO
INTRODUCTION: Cocaine is the only drug to show a rise in misuse between 1996 and 2007 in England and Wales. It can cause chest pain and myocardial infarction. This study assessed the prevalence of cocaine use in patients presenting with chest pain, and determined the association between cocaine use and chest pain. METHODS: Patients presenting with chest pain had a urine sample collected at presentation. Each patient with chest pain was matched with a non-chest pain control. Demographic detail, drug history and clinical outcome was recorded, samples anonymised and subsequently tested for cocaine and metabolites. RESULTS: Of the 1469 patients, 101 (6.9%) tested positive for cocaine compared with 3.8% of controls (p<0.001). Men (8%) were more likely than women (5.1%) to test positive for cocaine. Two patients developed a myocardial infarction. Cocaine use was highest in those aged 18-30 years for both sexes and decreased with age. Cocaine-positive patients with chest pain were more likely to present in the evening, after midnight or at the weekend. Only 18% of all patients presenting with chest pain had a specific drug history recorded in their notes. CONCLUSIONS: As many patients do not admit to use of an illegal drug, routine testing would enable cocaine-related ischaemic events to be identified more easily but this remains controversial. As management of cocaine-induced chest pain is different from other causes of chest pain, doctors should routinely question patients with chest pain about cocaine use in addition to well recognised risk factors.
Assuntos
Dor no Peito/epidemiologia , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Adolescente , Adulto , Dor no Peito/etiologia , Transtornos Relacionados ao Uso de Cocaína/complicações , Testes Diagnósticos de Rotina , Inglaterra/epidemiologia , Feminino , Humanos , Masculino , Anamnese/normas , Admissão do Paciente/estatística & dados numéricos , Admissão do Paciente/tendências , Fatores de Risco , Distribuição por Sexo , Resultado do Tratamento , País de Gales/epidemiologiaAssuntos
Nível de Saúde , Migrantes , Atenção à Saúde , Feminino , Humanos , Masculino , Polônia/etnologia , Reino UnidoRESUMO
KEY MESSAGES: Football is a high profile sport with a close relationship with alcohol, and many elite players have had problems with addiction. This can help raise public awareness of problem drinking. WHY THIS MATTERS TO US: We encounter alcohol problems daily in our different perspectives as a GP and an Accident and Emergency Consultant. Both of us are avid football fans.