Cocaine-induced myocardial infarction. A growing threat to men in their 30s.

A clear association has been established between cocaine use and acute myocardial infarction. Because of the continuing rise in cocaine use in the United States, many more young patients have or will have this disorder. Such patients are usually managed conservatively with calcium channel blockade and have an excellent in-hospital prognosis. If chest pain recurs or stress testing reveals evidence of ischemia, cardiac catheterization should be done. If cocaine use is discontinued, the long-term prognosis of a typical patient with cocaine-induced acute myocardial infarction is excellent in the absence of other chronic illnesses.