12-hour protocol safe for cocaine-associated chest pain

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12-hour protocol safe for cocaine-associated chest pain
PRACTICE RECOMMENDATIONS

A 12-hour emergency department observation period is safe for patients with cocaine-associated chest pain, provided they have symptoms consistent with low-to-intermediate likelihood of unstable angina according to the Braunwald classification, and normal serial troponin I levels and cardiogram.

Patients with traditional cardiac risk factors should undergo cardiac stress testing within 2 weeks following the chest pain event, as atherosclerosis enhances the vasoconstrictive effects of cocaine. All patients should be referred for substance abuse counseling, as recurrent cocaine use was associated with subsequent nonfatal myocardial infarction (MI).

 
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Practice Recommendations from Key Studies

Weber JE, Shofer FS, Larkin GL, et al. Validation of a brief observation period for patients with cocaine-associated chest pain. N Engl J Med 2003; 348:510–517.

Christy L. Arthur, MD
Mark H. Greenawald, MD
Carilion Family Practice Residency, Roanoke, Va. E-mail: [email protected].

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The Journal of Family Practice - 52(6)
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431-454
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Author and Disclosure Information

Practice Recommendations from Key Studies

Weber JE, Shofer FS, Larkin GL, et al. Validation of a brief observation period for patients with cocaine-associated chest pain. N Engl J Med 2003; 348:510–517.

Christy L. Arthur, MD
Mark H. Greenawald, MD
Carilion Family Practice Residency, Roanoke, Va. E-mail: [email protected].

Author and Disclosure Information

Practice Recommendations from Key Studies

Weber JE, Shofer FS, Larkin GL, et al. Validation of a brief observation period for patients with cocaine-associated chest pain. N Engl J Med 2003; 348:510–517.

Christy L. Arthur, MD
Mark H. Greenawald, MD
Carilion Family Practice Residency, Roanoke, Va. E-mail: [email protected].

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PRACTICE RECOMMENDATIONS

A 12-hour emergency department observation period is safe for patients with cocaine-associated chest pain, provided they have symptoms consistent with low-to-intermediate likelihood of unstable angina according to the Braunwald classification, and normal serial troponin I levels and cardiogram.

Patients with traditional cardiac risk factors should undergo cardiac stress testing within 2 weeks following the chest pain event, as atherosclerosis enhances the vasoconstrictive effects of cocaine. All patients should be referred for substance abuse counseling, as recurrent cocaine use was associated with subsequent nonfatal myocardial infarction (MI).

 
PRACTICE RECOMMENDATIONS

A 12-hour emergency department observation period is safe for patients with cocaine-associated chest pain, provided they have symptoms consistent with low-to-intermediate likelihood of unstable angina according to the Braunwald classification, and normal serial troponin I levels and cardiogram.

Patients with traditional cardiac risk factors should undergo cardiac stress testing within 2 weeks following the chest pain event, as atherosclerosis enhances the vasoconstrictive effects of cocaine. All patients should be referred for substance abuse counseling, as recurrent cocaine use was associated with subsequent nonfatal myocardial infarction (MI).

 
Issue
The Journal of Family Practice - 52(6)
Issue
The Journal of Family Practice - 52(6)
Page Number
431-454
Page Number
431-454
Publications
Publications
Topics
Article Type
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12-hour protocol safe for cocaine-associated chest pain
Display Headline
12-hour protocol safe for cocaine-associated chest pain
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