People can easily become addicted to the propulsive high that comes with cocaine use, but that intense stimulation can have detrimental effects on the heart that last much longer than any high. Cocaine’s unique effect on the body can lead to a bevy of cardiovascular problems—and in severe cases, it can even lead to fatal heart failure.

Cocaine Use in the United States

About 1.5 million people ages 12 and older reported using cocaine in the 2014 National Survey on Drug Use and Health. That same survey reported that an estimated 913,000 people in America met the criteria for cocaine dependency.

While those figures may not seem as high as those for other drugs—such as marijuana (19.8 million users, according to the survey) and prescription medications that are improperly used (6.5 million people)—cocaine still has a staggering impact. It causes the second-highest number of drug-related deaths in America, with only heroin triggering more fatalities, according to the Centers for Disease Control and Prevention. And cocaine is responsible for more than one in three emergency room visits related to drugs, according to the Drug Abuse Warning Network. One of the biggest problem areas is the relationship between cocaine and cardiovascular health.

How Cocaine Affects the Body, and the Cardiovascular System

Cocaine is a stimulant, which causes a rush in the body. Specifically, it triggers the sympathetic nervous system. This is the same system responsible for the body’s “fight or flight” response, the surge of adrenaline that occurs in times of crisis or high stress. With fight or flight, many of the body’s responses are heightened—the heart rate, blood pressure, breathing rate, and blood sugar levels are all elevated—and cocaine has a similar effect.

This intense response to cocaine and the resulting side effects put a tremendous strain on the heart. Unfortunately, cocaine also triggers reduced blood flow to the heart by constricting the capillaries. Because the muscle is working hard it needs all the oxygen it can get—but it can’t get it if blood isn’t properly flowing to the heart. The cardiovascular system can go into overdrive to make up for the reduced blood flow, which is one reason that there is an association between cocaine and heart attack risk. In fact, one study found that cocaine (along with marijuana) was responsible for 10% of heart attacks in people younger than 50. But the problems with cocaine and the cardiovascular system don’t stop at heart attacks.

Cocaine and Cardiovascular Conditions

Cocaine has an insidious effect on the heart. Damage can be caused by long-term use, or during the first time someone uses the drug. Problems can be acute or accumulate over time and become chronic health conditions. And, of course, in some cases they can be deadly. In addition to heart attacks, cocaine can also contribute to the following conditions:

  • Aortic dissection. This is where the aortic wall develops a tear. This causes blood to surge into the area, and it can be life-threatening if the aorta completely ruptures.
  • Arrhythmia. Cocaine can affect the rhythm of the heart, causing it to beat irregularly. In extreme cases, there could be a risk of tachycardia or ventricular fibrillation, both of which pose serious health risks.
  • Myocarditis. With cocaine use taxing the heart, it can become inflamed. Chronic inflammation may lead to damage that increases the risk of future heart failure. If caught in its early stages, myocarditis can be reduced if cocaine use stops.
  • Coronary artery aneurysm. This is another link between cocaine and heart attacks. When an aneurysm causes a bulge in the artery wall, there is a risk of it bursting and causing a heart attack.
  • Ischemic stroke. Data has found that there could be an association between stroke and cocaine use, especially in young people who normally would not be at risk for stroke. This is attributed to the strain cocaine puts on blood vessels and blood pressure.
  • Decreased systolic function. Both the left and right ventricle can be weakened by cocaine use. When that happens, blood cannot be pumped properly through the heart, and that may eventually lead to heart failure.
  • Atherosclerosis. Because cocaine use can over-stress the blood vessels of the heart, that can lead to hardening of the artery walls. Over time, the walls narrow and the heart can’t get enough blood. If part of this buildup breaks off the wall, it can cause a clot and possibly a heart attack.

Symptoms of Cardiovascular Problems

Many symptoms of cocaine-related heart issues are similar to heart problems that aren’t caused by drug use. Chest pain is a big warning sign, especially of serious, imminent problems. Heart rate is also affected, specifically if the heart is pumping abnormally slow or too quickly. Some people may also experience palpitations and sweating, especially if the heart is racing.

Cocaine can pose serious, life-altering risks to cardiovascular health. The consequences of cocaine use can be devastating and the only way to eliminate them is to stop using the drug and seek a professional drug rehab treatment. It will benefit your heart health, and your overall health in general.