Abstract
Severe cocaine toxicity causes acidemia and cardiac dysfunction. These manifestations
are described in 4 patients who presented with seizures, psychomotor agitation, and
cardiopulmonary arrest. Their initial laboratory values demonstrated acidemia and
electrocardiographic findings that included a prolonged QRS complex and QTc duration
and a right-ward T40 ms axis deviation. Treatment of the patients with hyperventilation,
sedation, active cooling, and sodium bicarbonate infusion led to the normalization
of their blood pHs and reversal of their cardiac conduction disorders. Acidemia can
contribute to cocaine cardiac disorders by promoting conduction delays, dysrhythmias,
and depressed myocardial contractility. Good supportive care corrects the blood pH
and cardiac conduction disorders and remains the major focus in the management of
patients with cocaine toxicity.
Keywords
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Article Info
Publication History
Accepted:
May 22,
1998
Received in revised form:
January 26,
1998
Received in revised form:
February 26,
1998
Received:
January 9,
1998
Identification
Copyright
© 1999 Published by Elsevier Inc.
