Cocaine use is well known to cause acute cardiovascular events, but chronic cardiomyopathy is a less common consequence. We present a 27-year-old male with five years of cocaine use who developed acute decompensated heart failure, marked by severe biventricular dilation, an ejection fraction of 19%, pulmonary hypertension, and multiorgan congestion. After inpatient stabilization, he was started on guideline-directed medical therapy and abstained from cocaine. This case underscores that even profound cardiac dysfunction from cocaine can be substantially reversible with early recognition, aggressive therapy, and substance cessation.
Dave et al. (Tue,) studied this question.