A cardiologist talks heart health.

How Bad Is Cocaine For The Heart?

Dr. Sanjay Gupta (no relation to the neurologist who is a contributor for CNN) is a heart specialist who practices medicine in York, England. He runs the YouTube channel York Cardiology that has 128,000 subscribers and over 8 million views.

Here is how he describes his YouTube channel:

I am Dr. Sanjay Gupta. I am a Consultant heart specialist in York, UK, and I believe that high quality, reliable jargon-free information about health should be available at no cost to everyone in the world.

Through my Youtube channel, I want to engage, educate and empower patients to take control of their health by addressing their lifestyles and preventing disease from happening in the first instance.

Most of all, I want people to stop being fearful and anxious about their health by getting them to focus on improving their quality of life and living fearlessly.

Dr. Gupta has over 20 years of experience. He was a guest on the Naked Diner Podcast (epsiode #168). We covered many topics. Fans of the show wrote questions for him. One of them was “How bad is cocaine for the heart?”

Here is his response.

I think cocaine is really dangerous for the heart. There are many things with cocaine. Number one, it causes an intense increase in the heart rate. So, it causes an increase in adrenaline, and the heart rate goes up. It also has the effect of causing blood vessels to spasm — to tighten up. That’s why you’ll see people who snort cocaine have perforated nasal septa because the blood vessels constrict.

What you have is revving up the heart, and you’re constricting the blood vessels making it difficult for the blood to travel. And it makes the blood more clottable. You introduce that into a blood vessel where the blood isn’t moving very much and when the heart is asking for more blood. It’s a terrible thing.

How much does it damage the heart? I can’t say every person damages their heart every time they do cocaine. But in general I think it is incredibly dangerous.

I just want to say it can cause sudden heart attacks because of the vessel spasms. But all that battering in the long run will leave the patient with a premature hardening of the blood vessels. So they will always be at a higher risk of bad things happening to their heart. Because of this long term damage to the blood vessels.

In the short term it’s really dangerous. But in the long term, you’ll wish you never did it when you’re older and wiser.

Here was another question from a fan:

My 9-year-old complains their heart races. Her doctor says not to worry, and won’t refer her to a cardiologist. Is this a normal childhood complaint or should I get her to a cardiologist?

And here is Dr. Gupta’s response:

I think it’s not uncommon for the heart to race. What you have to work out when someone complains about their heart racing is “Is the heart doing something funny?”

Is the heart choosing to race on its own accord with no external stimuli? For example, if you have a fever your body wants more blood to fight the infection. Your heart will go faster. If you have thyroid problems you have more thyroxin in your blood, then the thyroxin will make your heart beat faster.

On the other hand, there are some people whose heart will run faster on its own accord. Those are the interesting patients because: A, it’s important to make a diagnosis that the heart is doing something electrically abnormal; B, once you identify it you can potentially fix it.

So how do you differentiate the two? You use a heart monitor when the heart is going fast. You look at what’s happening. If the heart is going at an odd rhythm that will confirm the diagnosis.

At the very least that the patient should get some monitoring done. As a parent you want to make sure your child is going to be safe. You can get a heart scan to see if the heart is structurally normal. There may be a congenital problem that wasn’t picked up on at birth. If you have heart symptoms and underlying heart disease — whether its acquired heart disease or congenital heart disease — it is somewhat worse if you don’t have a structurally normal heart.

To know you have a strucrually normal heart is good information. It is less likely for something bad to happen if you have one. Knowing can be reassuring for the parent.

And here is one more question from our audience:

Frequently my heart feels like it has slowed down, and then I have trouble breathing. Is this normal?

And Dr. Gupta’s response:

I don’t think it’s normal, but I don’t think it’s something that makes me think something hideous is going on. If you are feeling symptoms that are making you feel uncomfortable, then it’s good idea to get some objective data and see what’s happening. If the patient says “My heart is slowing down, and that makes me feel unwell,” then the heart slowing down is relevant.

You want to monitor the heart and see if it is slowing down. Is it slowing down enough to cause the symptoms? If it is, we can fix the slow heart rate. Sometimes it’s caused by medications. In older patients the heart’s pace maker is getting worn down, and that can do it.

But if he said, “I feel my pulse slowing down and it doesn’t bother me.” I’d tell him not to worry about it. At the end of the day if it’s not making you feel unwell, don’t worry about it.

Of course. if he’s having symptoms, he should get them checked out, and get his heart monitored at the very least, just to see what’s going on with the heart rate.

If he has symptoms that only occur once a week, getting a heart monitor only for 24 hours isn’t going to help. We have to catch what’s happening as it’s happening.

I’m a comedy writer, podcaster, YouTuber, and activist. Millions have read my material and laughed. Support my work on Patreon: https://www.patreon.com/AndrewHa

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