Yes, drugs can cause heart attacks, and not only in older adults. Stimulants like cocaine and meth, inhaled chemicals, and even marijuana can strain or injure the heart, sometimes the first time they are used. If you are the parent of a teen, this guide covers which drugs affect the heart, the signs of heart damage from drugs, and when chest pain or a racing heart means calling 911.

Drug Use and Heart Health

Many people associate drug use with issues like addiction, mental health problems, or social difficulties. However, the cardiovascular implications of drug use are often overlooked. This section will discuss the impact of cocaine and prescription opioids on heart health, providing insights into the question: "Can drugs cause heart attacks?"

Impact of Cocaine on Heart Health

Cocaine is a potent stimulant drug known for its severe impact on the cardiovascular system. Studies have shown that one in four myocardial infarcts in people aged 18-45 years can be linked to cocaine use, suggesting that the drug's role in heart issues may be underreported [1].

Cocaine's adverse effects on the cardiovascular system are predominantly related to activation of the sympathetic nervous system. This activation can lead to serious cardiovascular complications, including acute conditions such as arrhythmias and myocardial infarction, as well as chronic conditions like cardiomyopathy and coronary artery disease.

The cardiotoxicity of cocaine can result in sudden death, with acute coronary events typically occurring within minutes to hours after cocaine administration. The mechanisms behind cocaine-induced myocardial infarction are multifactorial, involving increased myocardial oxygen demand, reduced oxygen supply due to vasoconstriction, and enhanced thrombosis [2].

Moreover, cocaine use affects eating behavior and suppresses appetite, which can lead to malnutrition and anorexia due to disruption of the metabolic process and neuroendocrine regulation. Chronic exposure to cocaine can increase the risk of health conditions like hypertension, body weight problems, diabetes, and metabolic syndrome [2].

Effects of Prescription Opioids on Cardiovascular Health

Prescription opioids, while beneficial for managing severe pain, can also pose significant risks to cardiovascular health. These medications depress the central nervous system, slowing breathing and reducing blood pressure. Over time, this can lead to a range of cardiovascular problems, from irregular heart rhythms to acute myocardial infarction, particularly in individuals who misuse or abuse these medications.

The risk is particularly high among individuals with existing cardiovascular conditions or risk factors, such as hypertension or high cholesterol. Furthermore, sudden cessation of opioids in people who are dependent can lead to a surge in sympathetic nervous system activity, potentially triggering acute cardiovascular events.

Understanding the cardiovascular risks associated with drug use can help families spot a problem early and seek appropriate treatment when necessary. In the following sections, we'll explore the cardiovascular risks associated with other common drugs and discuss strategies for reducing these risks.

Common Drugs and Cardiovascular Risks

In the context of heart health, it is critical to consider the impact of common recreational drugs. These substances, including amphetamines, marijuana, and ecstasy, can pose significant risks to the cardiovascular system.

Amphetamines and Heart Health

Cocaine, ecstasy, and amphetamines share similar adverse effects on the cardiovascular system, related predominantly to the activation of the sympathetic nervous system. Serious cardiovascular complications have been well documented for these drugs, including increased heart rate, blood pressure, and constriction of blood vessels. This can lead to significant stress on the heart and potentially result in heart attack or stroke [1].

Marijuana Use and Heart Function

The active compound in marijuana, tetrahydrocannabinol (THC), has been associated with increased angina frequency, likely due to a decrease in the angina threshold, diminished sympathetic and parasympathetic nervous system signal transduction, serum aldosterone increases, central and peripheral vasoconstriction, and hypertension (HTN). Researchers have also linked marijuana use to higher blood pressure and to heart attacks in some younger users who had no other risk factors [1].

Ecstasy and Cardiovascular Complications

Ecstasy, also known as MDMA, shares similar cardiovascular risks with cocaine and amphetamines due to the activation of the sympathetic nervous system. This can lead to increased heart rate, blood pressure, and constriction of blood vessels, which can significantly stress the heart. Over time, these effects can potentially result in a heart attack or stroke. Additionally, ecstasy can cause dehydration and hyperthermia, which can further exacerbate cardiovascular risks.

These findings underscore the potential dangers of drug use in relation to heart health. By understanding these risks, individuals can make informed decisions about their health and take steps to reduce their risk of cardiovascular complications.

Cardiac Effects of Substance Misuse

Substance misuse is known to have detrimental effects on overall health, but the impact on heart health is often overlooked. Various substances, including narcotic analgesics and volatile substances, can lead to serious heart conditions. This section explores the relationship between these types of substances and heart health in more detail.

Narcotic Analgesics and Heart Conditions

Narcotic analgesics, such as morphine and heroin, are commonly misused substances that have a significant impact on heart health. These substances can lead to various heart conditions, including bradyarrhythmias and tachyarrhythmias.

Bradyarrhythmias are conditions where the heart rate is slower than normal, while tachyarrhythmias refer to conditions where the heart rate is faster than normal. Both conditions can result in inadequate blood flow to the body, leading to a range of symptoms from dizziness and fatigue to more serious complications like heart failure or sudden cardiac death.

Volatile Substance Misuse and Cardiac Arrhythmias

Volatile substances, such as butane gas lighter refills, are often misused, especially among adolescents. The misuse of these substances can lead to severe cardiac arrhythmias, which are often the main cause of sudden cardiac death in this age group. NIDA warns that this "sudden sniffing death" can happen even when a person uses inhalants just one time [4].

The cardiac arrhythmias caused by volatile substances can result from sympathetic activation or myocardial sensitization to circulating catecholamines. Sympathetic activation refers to the body's "fight or flight" response, which can increase heart rate and blood pressure. Myocardial sensitization, on the other hand, refers to the heart muscle becoming more responsive to substances like catecholamines, which can also increase heart rate and potentially lead to life-threatening heart rhythms.

In conclusion, the misuse of narcotic analgesics and volatile substances can lead to serious heart conditions, including various types of arrhythmias. These findings underscore the importance of substance use prevention and intervention efforts, particularly for vulnerable populations such as adolescents. It's crucial to continue researching the cardiac effects of substance misuse to further understand these relationships and develop effective strategies for prevention and treatment.

Drugs and Heart Disease: Long-Term Damage

Heart attacks get the headlines, but some drugs also cause slower heart disease that builds over months or years of use:

Cocaine: Repeated use can stiffen and thicken the heart muscle, speed up hardening of the arteries, and inflame the heart muscle [2]. Chest pain that feels like a heart attack is one of the most common reasons people who use cocaine end up in the emergency room [3].
Methamphetamine and other amphetamines: Like cocaine, they push heart rate and blood pressure up and narrow blood vessels, and long-term use is linked to a weakened, enlarged heart (cardiomyopathy) [1].
Cocaine with alcohol: Together they form cocaethylene in the liver, which may increase the toxic effects of both drugs on the heart [3]. We cover this in more detail in the dangers of mixing cocaine and alcohol.
Inhalants: Chemicals from aerosols and solvents can trigger fast, irregular heart rhythms and fatal heart failure within minutes of use [4].

Some of this damage improves after a person stops using. Some does not. That is one more reason early help matters for a teen.

Signs of Heart Damage From Drugs

Heart problems from drug use do not always look dramatic. Watch for:

Chest pain, pressure, or tightness, or pain that spreads to the arm, jaw, or back
A racing, pounding, or irregular heartbeat
Shortness of breath, especially with light activity
Dizziness, fainting, or nearly fainting
Unusual tiredness, or swelling in the feet and ankles

Chest pain, trouble breathing, or fainting after using any substance is an emergency. Call 911 right away and tell responders what your teen may have taken, because it can change the care they give [5].

Can a Teenager Have a Heart Attack From Drugs?

It is uncommon, but yes. Cocaine can cause a heart attack in young people with healthy hearts, and inhalants can stop a teen's heart even with first-time use [3][4]. Pills and powders bought from friends or through social media can also contain stimulants or other drugs the teen did not know they were taking.

As a parent, pay attention if your teen complains of chest pain or a racing heart after a party, seems unusually wired or can't sleep, or has new nosebleeds, weight loss, or a chemical smell on their clothes. Our guide to the physical symptoms of cocaine addiction covers more of the signs to look for.

Getting Help for a Teen Who Is Using

If drug use has already caused a scare, the next step is a full medical check and an honest conversation about what your teen is using. If your teen needs help stopping, our residential treatment program in Winter Springs, near Orlando, gives teens a structured place to get well, and our family program helps parents rebuild trust at home. Call us at (321) 220-3631 to talk through what you are seeing.