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Can we get chest pain due to cocaine?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Sushrutha M.

Published At November 30, 2020
Reviewed AtJune 30, 2023

Patient's Query

Hello doctor,

I used cocaine every now for 12 to 18 months, sometimes two times a month, sometimes not at all, roughly for two and a half to three years ago (I have not touched it since). I have no family history of heart problems. My family actually has incredible cardiac genes. Since the last time I used it (a handful of times on a weekend only before two years) time I felt light-headed and thought I was going to pass out but was also very dehydrated and felt fine after having water and Gatorade 20 minutes later. I had an odd chest discomfort three days later. I thought I was having a mini heart attack and went to the ER three days later. At the ER, I told them I did cocaine and took an EKG, T-test for troponin, and chest X-ray. Everything came back normal. The chest pain was not severe. I believe I had an anxiety attack, and the doctors sent me home with no prescriptions and a clean bill of health. Since then, I saw how horrible cocaine is for your body and vowed never to use it again as it is pointless in the risk this has also given me anxiety. Now and then, I have a dull left chest pain around the lower and mid pec, sometimes arm and neck, which feels like anything from indigestion or muscle-ligament strain. I am an avid weight lifter, so I do not discount injuries. I also had jaw pain and consulted a dentist. The doctor told me that it was due to TMJ. My internal medicine doctor told me not to worry about it. That I did not use long enough or frequent enough and that I did not overdose, or I would have had severe repercussions that water could not cure and all my current cholesterol, triglycerides, and blood pressure is healthy. However, at times I get these aches (one out of ten on the pain scale very dull), and I wonder if I have long-term damage to my heart by atherosclerosis or LV damage, or fibrosis of sorts. Whenever I feel chest pain, I either run on the treadmill or do jumping jacks and spike my heart rate to confirm it is not cardiac related. Given the info above, should I seek further cardiac testing and treatment? Can your heart heal after three years of quitting? Am I unreasonable, or should I source additional testing? I have no shortness of breath, can do a full workout, do not have any other symptoms other than palpitations which could be caused by stress or anxiety? Whenever I get a twinge of discomfort in my jaw, neck, or left chest, I immediately assume it is a heart attack. Either I get these pains on the left side due to cardiac problems or anxiety and hyper-focus. I am taking Vitamin D and Singulair tablets. Kindly give your opinion.

Hello,

Welcome to icliniq.com.

It is very unlikely to be cardiac pain. It is not cocaine-related now. Cocaine can cause heart issues when consumed in high doses and present in the body because of coronary artery vasospasm. Otherwise, if consumed for a long time, say many years or decades, to cause atherosclerosis. With your level of consumption, it is very unlikely to have caused any permanent damage. However, cocaine just made you aware of such pains, which might be occurring before and precipitated your anxiety. So you have become more sensitive to the nonspecific pains which are going to occur every now and then, especially with workouts or gastric reflux. So I do not think there is anything to worry about it. And if it were a heart-related issue, then full workouts would not be possible. Either one will get severe breathlessness, chest pain, or a heart attack. Also, cardiac symptoms would be very consistent, meaning coming every time you have heavy activities. I hope this was helpful.

Patient's Query

Hello doctor,

Thank you. Therefore any chest pain when deep breathing is most likely from a strained muscle by working out. I can run a quarter-mile in about one and a half hours but have had a chest ache right above my solar plexus, something I only feel when deep breathing. This would not be a sign of myocarditis, right? Kindly give your opinion.

Hello,

Welcome back to icliniq.com.

Pain in deep breathing is not related to coronary artery disease. It is also not related to myocarditis, but pericarditis or pleurisy (inflammation of lungs linings) can cause such pain. But these pains are quite sharp like someone is pricking a needle inside, and one cannot take deep breaths. There would be no relationship to workouts. Again these do not last more than few days usually. So yours is unlikely to be related to these. The likely cause is muscle stretch or strains over the chest cartilages due to workouts. One can also feel pain on pressing over the area. I hope this was helpful.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sagar Ramesh Makode
Dr. Sagar Ramesh Makode

Cardiology

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