CRACK COCAINE CAN TEAR OPEN MAJOR BLOOD VESSEL

ANAHEIM (Reuters Health) - Cocaine use--especially crack--can lead to an
often-fatal rip in the major blood vessel leaving the heart, California
researchers reported here at the American Heart Association's annual
scientific sessions.

The rip or tear, known as aortic dissection, is normally very rare. The
condition is fatal unless the patient receives emergency surgery in time.
About half of patients die within 48 hours if left untreated.

There are fewer than 1,000 cases of aortic dissection a year, Dr. Priscilla
Y. Hsue of the University of California, San Francisco, told Reuters Health
on Tuesday, but she and her colleagues at San Francisco General Hospital
noticed what seemed to be an unusually high incidence of the condition
among cocaine users.

This led them to analyze all cases of aortic dissection at that inner-city
institution in the past 20 years. They identified 38 cases, with 14
directly related to cocaine use. All but one patient had used the drug in
the form of crack cocaine.

"This is 37% of the whole group," Hsue commented, a significantly high
percentage.

Hsue said all 14 of the cocaine-related cases were smokers. Their average
age was 41, compared with 59 for the cases that were not related to cocaine
use. The cocaine users had often been on drug binges just before arriving
at the hospital.

High blood pressure is a risk factor for aortic dissection, Hsue noted, as
is blood vessel wall stiffness, which smoking can cause. A stiff aorta
under high pressure that is increased even further by cocaine use is a
recipe for disaster, according to Hsue.

Doctors and nurses should suspect aortic dissection in cocaine users with
chest pain, Hsue told Reuters Health.