An angiographic and histologic study of cocaine-induced chest pain

Chest pain is not an uncommon symptom in patients who abuse cocaine. A small number also develop acute myocardial infarction.^1,2 Most, however, show electrocardiographic ST-segment or T-wave abnormalities as the only objective evidence of myocardial ischemia. Coronary artery spasm has been popularly invoked as the possible cause for chest pain.^3,4 However, evidence for spasm is largely circumstantial at present. An alternative source of pain may be myocarditis,⁵ which has been demonstrated in some patients dying of cocaine abuse.^6,7.