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Cocaine Use and Heart Problems

Cocaine Use and Heart Problems

Frequent cocaine use can cause many negative physical effects, including death.

It can affect many parts of the body, including the heart. According to the American Heart Association, cocaine use increases several risk factors for heart attacks and strokes.1 Many more deaths are caused by cocaine’s damage to the heart.

How Cocaine Affects the Heart

Because cocaine acts as a stimulant, it quickly increases the amount of adrenaline and other activating substances throughout the body, similar to how the body would react in a frightening situation.The adrenaline causes an increase in heart rate and blood pressure, and these changes can cause chest pain.3

Chest pain is fairly common among cocaine users and accounts for 40 percent of emergency room visits by cocaine users, making it the most common reason behind visits.1
There are other common cardiovascular problems that cocaine users often experience. Rapid heart rate and abnormal rhythms are also common.

Users may also experience disease of the heart muscle fibers, which is called cardiomyopathy. This leads to enlarged heart ventricles. When the walls of the aorta weaken, they can dissect or rupture.3 Even sporadic use of cocaine can cause arteries to narrow and blood flow to decrease, which can lead to chest pain caused by cardiovascular system malfunction, also known as angina.4 This can be the warning symptom to the onset of a heart attack.5

The stimulation of the heart caused by cocaine use can also lead to abnormal heart rhythms, which are known as arrhythmias.6

According to the American Heart Association, cocaine can cause other negative effects on the heart, including myocarditis, which is inflammation of heart muscle fibers.  The inner lining of the heart can also become inflamed or infected due to bacteria introduced into the bloodstream from cocaine injection and cause endocarditis. A cocaine user can also develop pulmonary edema, or fluid in the lungs. Blood vessels in the heart can develop blood clots and result in vascular thrombosis.1

Cocaine Use Increasing

After a brief decline in cocaine use in the 2000s, cocaine use has been back on the rise among youth since 2009. Not only can it be obtained fairly easily in some areas, but it can be administered various ways. It does not need to be injected, so those who are scared of needles can snort or smoke the drug to achieve a high. Crack cocaine has the same potency as powder cocaine, but its effects are stronger because smoking crack cocaine increases its availability to the body compared to snorting powder cocaine.Crack is less expensive and more widely available, making it a viable alternative to powder cocaine. However, its increased availability and effects, in theory, make heart problems even more of a risk. Young people and those who are otherwise healthy could suffer from heart attacks and strokes from frequent use of crack cocaine. Even first-time users are at risk.

Risk Factors for Heart Problems

Cocaine can cause heart problems for anyone who uses the drug. However, certain situations of cocaine use are more susceptible to these problems:6

  • First-time use of cocaine.
  • Use of cocaine by patients with existing heart disease.
  • Use by pregnant women
  • Concurrent use of cocaine and alcohol.


  1. American Heart Association. (2015). Illegal Drugs and Heart Disease.
  2. Kim, S. T., Park, T. (2019). Acute and Chronic Effects of Cocaine on Cardiovascular Health. Int J Mol Sci, 20(3), 584.
  3. Egred, M., Davis, G.K. (2005). Cocaine and the heart. Postgraduate Medical Journal, 81, 568-571.
  4. Finkel, J.B., Marhefka, G.D. (2011). Rethinking Cocaine-Associated Chest Pain and Acute Coronary Syndromes. Mayo Clin Proc, 86(12), 1198-1207.
  5. Qureshi, A.I., Chaudhry, S.A., Suri, M.F. (2014). Cocaine use and the likelihood of cardiovascular and all-cause mortality: data from the Third National Health and Nutrition Examination Survey Mortality Follow-up Study. J Vasc Interv Neurol, 7(1), 76-82.
  6. Hoffman, R.S. (2010). Treatment of patients with cocaine-induced arrhythmias: bringing the bench to the bedside. Br J Clin Pharmacol, 69(5), 448-457.
  7. Schneider, K. E., Krawczyk, N., Xuan, Z., Johnson, R. M. (2018). Past 15-year trends in lifetime cocaine use among US high school students. Drug Alcohol Depend, 183, 69–72.

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