Beta blockers have long thought to be contraindicated in patients with cocaine-associated chest pain. In this retrospective single center analysis of 331 patients with chest pain and cocaine-positive drug screens, almost half received a beta blocker. There was no significant differences in EKG changes or troponin levels between those that did and did not receive a beta blocker, but those discharged on a beta blocker had significantly lower long term cardiovascular mortality. Use of beta blockers appears to be safe in patients with cocaine-associated chest pain, and may actually improve long term mortality (abstract)
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