Profound acute limb ischemia affecting all four limbs following cocaine inhalation.

Recreational drug use is a recognized cause of a number of acute vascular events. Cocaine is associated with a number of cardiovascular diseases, including myocardial ischemia, arrhythmias, and aortic dissection. Cutting agents are commonly used to dilute the amount of cocaine required to enhance the profits of the seller. Such cutting agents themselves often provoke acute vascular disease. We present the case of a 34-year-old female presenting with profound ischemia affecting all four limbs secondary to cocaine inhalation.