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Cocaine - sudden death updated 04/01/02

1st article

Sudden death from cocaine is usually related to either subarachnoid hemorrhage, heart attack (coronary thrombosis), or cardiac arrhythmia. The mechanism of SAH is poorly understood but is probably due to a sudden rise in cerebral blood pressure caused by the drug, followed by rupture of a vulnerable blood vessel within the brain. 
Dr. Martin is Chief of the Division of Pulmonary and Critical Care Medicine, Mt. Sinai Medical Center, One Mt. Sinai Drive, Cleveland, Ohio, 44106 (Phone 216-421-3708; FAX 216-421-6952). Send e-mail to martin@lightstream.net

2nd article

In Cardiac Arrest - the science and practice of resuscitation medicine, 1996

chapter 42 Toxicologic Sudden Death by Lewis S nelson MD and Robert S. Hoffman MD  

"Large doses of cocaine, however, are directly toxic to the myocardium, an effect equivalent to the membrane-sustaining activity of the cyclic antidepressants, and result in negative inotropy and dysrhythmias."

"Substantial literature documents the connection between cocaine use and myocardial ischemia."

"Cocaine-related myocardial ischemia may result in dysrhythmias that cannot be differentiated from those of coronary artery disease."

quotes are from pg 776-779