AP PSYCHOLOGY

Detailed explanation-1: -Cocaine affects the cardiovascular system through 2 major pathways: increased sympathetic output and a local anesthetic effect. Through increased sympathetic tone and catecholamine levels, cocaine increases heart rate, blood pressure, and myocardial contractility, all of which increase myocardial oxygen demand.

Detailed explanation-2: -Up to 84% of patients with cocaine induced chest pain may have an abnormal ECG and up to 43% of cocaine misusers without MI may have ST segment elevation in two or more ECG leads that may even meet the thrombolysis criteria. The reported ECG sensitivity for detecting cocaine induced MI is 36% with a 90 % specificity.

Detailed explanation-3: -This suggest that cocaine-induced coronary ischaemia may result from microvascular constriction, which is only partially prevented by alpha 1 blockade. In addition, direct toxic effects of cocaine on the myocardium may also contribute to the development of cardiogenic shock.

Detailed explanation-4: -By increasing heart rate, blood pressure, and contractility, cocaine leads to increased myocardial demand. Even small doses of cocaine taken intranasally have been associated with vasoconstriction of coronary arteries.