Emergency department presentations with suspected acute coronary syndrome--frequency of self-reported cocaine use.

The objective of this study was to assess the prevalence of self-reported cocaine use in individuals presenting to the Emergency Department (ED) with suspected myocardial ischaemia/acute coronary syndrome (ACS). A retrospective review (1 January to 31 December 2008) of all suspected myocardial ischaemia/ACS presentations to our ED was undertaken. Basic demographic data and use/nonuse of cocaine were recorded from notes; where appropriate the route of use, concomitant use of other recreational drugs/ethanol, presenting features and treatment(s) were extracted. Self-reported cocaine use was recorded in 54 (1.9%) of the 2810 presentations. The mean+/-SD age of those who self-reported the use of cocaine (28.9+/-9.0) was significantly lower than those who did not (52.3+/-12.7) (P<0.0001). Twenty (37.0%) of those with cocaine use had one or more features of potential cocaine (sympathomimetic) toxicity at presentation to the ED. In conclusion, self-reported recent cocaine use was documented in a clinically significant minority of patients with suspected myocardial ischaemia/ACS.