Cardiac MRI helps diagnose cocaine-related heart damage

Cardiac MRI can detect cocaine’s impact on the cardiovascular system and help differentiate between a wide range of heart diseases, according to a new literature review study published in Radiology: Cardiothoracic Imaging.

Cocaine abuse is a global problem. The 2014 National Survey on Drug Use and Health found an estimated 1.5 million cocaine users aged 12 or older in the U.S. alone.

It’s overuse can have serious short-term effects on the heart, including sudden attacks such as heart attacks and acute myocarditis along with chronic effects like cardiomyopathy. Distinguishing between such conditions is difficult, but critical to proper care.

Unlike typical diagnostic strategies, such as electrocardiogram, stress testing and coronary angiography, cardiac MRI allows for microscopic views into living heart tissue, helpful for diagnosing heart diseases, noted senior author Marco Francone, MD, PhD, from Sapienza University in Rome, in a prepared statement.

"Cardiac MRI's ability to distinguish between the different cardiac manifestations of cocaine abuse is important because they all have different patterns," Francone added. "Even though all these pathologies have cocaine abuse as primary cause, the myocardial damage and, therefore, clinical course are completely different, ranging from complete recovery to heart failure."

Francone emphasized that cardiac MRI is particularly strong at diagnosing the types of cardiomyopathies that make up the chronic effects of cocaine abuse. By assessing ventricular function clinicians can identify which phase of chronic cardiomyopathy a patient may be experiencing.

"The real challenge is early diagnosis of cocaine-induced cardiomyopathy and, in particular, its asymptomatic stage," Francone said. "Early diagnosis can indeed have a significant impact on clinical outcome, preventing evolution to heart failure."

In the study, the authors suggested that to better diagnose cocaine-induced changes to the heart physicians should consult data such as age, gender, clinical assessment and history of drug use and laboratory findings together with cardiac MRI results.