Cocaine induced vasospasm and post attack flu - Heart Disorders Message Board

Perry2 · 09-30-2003, 08:00 PM

A couple of weeks ago I went to the Dr for chest pain thinking it was a complication of a stubborn flu. I was tested positive for the Troponin enzyme and told I had suffered something in between an Angina and an MI. They related it to Cocaine I had used 3 days prior to the attack and I think one of the Drs described it as vasospasm. My EKG and heart xray were normal. 4 days later I had a stress test which was normal except for weakness associated with the flu. The next day however I felt ill and went back to the hospital. They ran EKG and Troponin again and this time both were normal. It may have been just anxiety and the flu(2 weeks old by that time) but they booked me for an ultrasound of my heart and I booked myself for a cholesterol test. I have not had these last 2 yet.

My concern is, can vasospasm cause the same Troponin levels as an MI and given they did not seem fit to put me off work or even give me aspirin how long before I resume full activities?
I am a 41 year old natural bodybuilder and having sworn off the Coke, can I return to the gym?

What are the long term affects of vasospasm with a positive Troponin test? Every time I get a twinge from the flu now or have a bit of heartburn I get nervous.

The funny thing is, the initial chest pain hit me for an hour or two after a couple of beers and some spicy food but there were no other discomforts so I never suspected heart problems. Two weeks later I had some beer and the same spicy food and woke up with what felt like the same chest pain but I took some antacid and it cleared up right away. I am thinking the chest pain that brought me to the Dr in the first place was G/I discomfort and it was just a fluke that I had actually sustained heart damage at around the same time.

CobaltBlue · 10-01-2003, 05:13 AM

Quote:

Originally posted by Perry2:
What are the long term affects of vasospasm with a positive Troponin test? Every time I get a twinge from the flu now or have a bit of heartburn I get nervous.

Perry,

Elevated troponin indicates that you had an MI. Since you are a bodybuilder, elevated CPK would be less diagnostic in your case, because you routinely damage muscles while building them.

When I was admitted to the hospital at age 35, they found elevated troponin in me also, because I had a MI. They also checked me for cocaine use since younger people like you and I don't normally have CHD. Unfortunately I do, but I digress.

Cocaine can cause a spasm in the artery, which essentially produced the same effect as a plaque filled occluded artery. During this time you may experience angina, and if the spasms subsists long enough, heart tissue damage will occur (MI) and elevated troponin levels will follow. The greater the damage, the more elevated your troponin will be and I think the more rapidly it will show up in a blood draw.

I am surprised that the doctors did not advise you better if they suspected heart damage. After mine, I begged to go back to work, but they told me to take it easy for 1 week then start off slow. There is a specific period after an MI which, if you exercise strenuously, can further damage the heart muscle tissue. I think that the time period was 3 weeks, but you probably want to check with a cardiologist.

Good luck Perry.