NREMT Emergency Medical Technician (EMT) Cognitive ExamMedical EmergenciesMedium
A 22-year-old female presents with sudden onset of severe, crushing chest pain that radiates to her left arm. She states she has a history of recreational drug use. Her vital signs are BP 160/100 mmHg, HR 110 bpm, RR 20 bpm. Which substance is MOST likely associated with these symptoms in this patient?
- AHeroin.
- BCocaine.
- CMarijuana.
- DAlcohol.
Show answer & explanationAnswer & explanation
Correct answer: B. Cocaine.
Cocaine use is well-known to cause vasoconstriction, increased myocardial oxygen demand, and platelet aggregation, leading to acute coronary syndromes, even in young individuals. The patient's symptoms (crushing chest pain radiating to the arm) and vital signs (hypertension, tachycardia) are consistent with a cocaine-induced myocardial infarction.
Why the other options are wrong
- A. Heroin is an opioid, typically causing respiratory depression, bradycardia, and hypotension, not crushing chest pain and hypertension.
- C. Marijuana typically causes tachycardia but is not strongly associated with acute coronary syndromes.
- D. Acute alcohol intoxication causes central nervous system depression; chronic use can lead to cardiomyopathy, but not typically acute crushing chest pain like this.
Cocaine-Induced Chest Pain
Cocaine use can lead to acute coronary syndromes, including myocardial infarction, due to its effects on vasoconstriction, increased heart rate and blood pressure, and enhanced platelet aggregation.
- Can occur in young, otherwise healthy individuals.
- Presents with typical cardiac chest pain symptoms.
- Often accompanied by hypertension and tachycardia.
- Requires aggressive management similar to other acute coronary syndromes.
Memory trick: Stimulants can 'Coke' your heart!