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PVC and PANIC ATTACK after being sober from COCAINE ABUSE.

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I was a recreational cocaine abuser (at peak 1g/week) for about 2 years. After being sober ~1 month (and having taken steps to never abuse again), I have had a panic attack and PVCs - 24 hour holter showed 2900 in 24 hours. I can exercise as normal, and have no shortness of breath. Both primary and cardiologist say heart sounds fine, and i have stress and echo scheduled friday.
In your opinion, would these PVCs be caused by cocaine use, and permanent? They're giving me considerable anxiety.

Category: Cardiologist

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Category: Cardiologist
Dr. Vivek Mahajan is online now

Expert:  Dr. Vivek Mahajan replied 4 Days.

Hello. Thank you for your query at DoctorSpring.com.
You have been off cocaine for a month. That is a good thing. Now you have recurrent PVCs.
Long term cocaine abuse can cause cardiomyopathy (heart muscle abnormality), Left ventricular (LV) dysfunction and hypertrophy (thickening) of left ventricle. Cocaine causes systolic (heart contraction) and diastolic (heart relaxation) dysfunction, arrhythmias, and atherosclerosis. Cocaine decreases myocardial (heart muscle) contractility and ejection fraction (pumping ability of heart).

Usually in 90 to 95 percent people this cardiomyopathy reverts on its own. However, in a small percentage the heart remains weak. Also, if there was a silent heart attack during the cocaine use then it may lead to weak heart. Weak heart can lead to multople arrhythmias like PVCs. However, this can only be confirmed aftwr a 2D ECHO. If your 2D ECHO is normal then there is nothing to worry about the PVCs. Then, it may be managed with beta blockers but if you promise to abstain because beta blockers along with cocaine use can be dangerous. So the major treatment decisions and prognosis will depend on whether the heart function is normal or not on the 2D ECHO examination. And also, treatment will depend on whether you are going to abstain with surety.

Feel free to ask further queries.
Regards, Dr Vivek Mahajan,
MD Medicine, DM Cardiology.

Dr. Vivek Mahajan
Category: Cardiologist
Fellowship: DM, Cardiology, PGIMER, 2013
Residency: MD, Internal Medicine, AIIMS, 2007
Internship: King Edward Memorial (KEM) Hospital, 2003 
Medical School: MBBS, Seth G.S. Medical College, 2002
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