Letter to the Editor
Response to Cardiovascular Toxicity
Abstract
I enjoyed reading the recent review on the cardiovascular effects of cocaine by Karch,1 but was disappointed that our ideas and research regarding cocaine’s electrophysiology and its ability to provoke arrhythmias2–5 were not cited. In particular, the readers of the Journalare referred to a 2002 publication5 that we prepared which summarizes our original work and that of others. In this paper, we construct two distinct profiles of patients with cocaine-induced arrhythmias (overdose situations—slow monomorphic ventricular tachycardia and recreational users—torsade de pointes) based upon published case reports combined with cocaine’s basic effects on conduction and ion channels (fast on-off potassium blockade at low concentrations and slow on-off sodium blockade at higher levels). We further offer the possibility of a genetic predisposition of some patients to these events. Most of our thoughts and findings are clearly echoed in the paper by Karch, but for some reason we were not given credit.This content is limited to qualifying members.
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