Cocaine Abuse: An Attack to the Cardiovascular System-Insights from Cardiovascular MRI.
Gianluca de RubeisFederica CatapanoGiulia CundariAndrea AscioneNicola GaleaCarlo CatalanoMarco FranconePublished in: Radiology. Cardiothoracic imaging (2019)
Cocaine is the most commonly used illicit drug in the European Union. Its cardiac effects are numerous and diverse, both in acute and chronic abuse, and include myocardial infarction, myocarditis, catecholamine-induced cardiomyopathy, and chronic cardiomyopathy (subclinical, hypertrophic, and dilated phases). Their clinical manifestations are vastly overlapping, and differential diagnosis should be performed using a thorough diagnostic workup featuring clinical history, laboratory tests, electrocardiography, stress test, noninvasive imaging modalities, and coronary angiography. Cardiac MRI has the unique ability of in vivo tissue characterization. This unique feature can play a pivotal role in the differential diagnosis through proper characterization of the myocardial tissue. Especially in acute settings, cardiac MRI makes it possible to distinguish between cocaine-induced myocardial infarction, cocaine-induced myocarditis, and catecholamine-induced cardiomyopathy. Conversely, in chronic cardiomyopathy, cardiac MRI permits evaluation of ventricular function and myocardial tissue, allowing the investigation of the underlying cause. On the one hand, assessing the ventricular function permits differentiation among subclinical, hypertrophic, and dilated phases of chronic cardiomyopathy; on the other hand, cardiac MRI could classify the causes underlying remodeling, including chronic ischemic injury, chronic myocarditis, and cardiac motion impairment. This review analyzes the relationship between pathophysiology, histology, and disease using the existing literature on cardiac MRI cocaine abuse evaluation. © RSNA, 2019.
Keyphrases
- left ventricular
- drug induced
- heart failure
- contrast enhanced
- magnetic resonance imaging
- high glucose
- diffusion weighted imaging
- diabetic rats
- computed tomography
- liver failure
- high resolution
- magnetic resonance
- machine learning
- oxidative stress
- blood brain barrier
- hepatitis b virus
- deep learning
- prefrontal cortex
- heat stress
- brain injury
- electronic health record
- fluorescence imaging
- cerebral ischemia
- high speed