Hello doctor, I have been taking cocaine once a week for 20 years and on the 1st of last month, I started getting a cough and breathless. It was getting worse when the cocaine wore off. Anyway, I had an ECG which was clear and a 24-hour tape also clear. CT scan on lungs clear. Then I had an ultrasound and came back with mild apical anterior hypokinesis RWMA. The cardiologist said he will see me next month and did not seem bothered. Anyway, I still was doing cocaine and drinking weekends because it is the only time I do not feel breathless but on a Wednesday, when everything is out of my system, I get breathless again and heavy chest. Can you please tell me if I do not do cocaine again, will I get better or am I mucked up for life now?
Hello. Firstly, cocaine has got a wide range of effects on the heart. So, hypokinesia means there is some damage to the heart which may be due to cocaine or may be due to coexistent coronary artery disease. So, you will need coronary angiography preferably, conventional and CT angiography is the alternative. Also, since hypokinesia is observer dependent, sometimes reported milder hypokinesia may not be actually present and false positive findings are possible. But, we should get it confirmed by further investigations. This much hypokinesia should not cause breathlessness in you, rather it appears to be related to cocaine withdrawal only. Also, I guess you do not have gastric/reflux symptoms. Cocaine withdrawal symptoms usually settle in a few weeks without treatment. It is better you reduce consumption gradually over the next few weeks, then stop, rather than abruptly stopping. So, once we rule out heart disease, then you can get back to normal life after quitting its consumption.