Cocaine-induced epicardial coronary artery thrombosis resulting in extensive myocardial injury assessed by cardiac magnetic resonance imaging

Cocaine causes myocardial injury through multiple mechanisms including vasoconstriction, adrenergic hyper-stimulation, and de novo thrombus formation. This report presents two cases of cocaine-induced coronary artery thrombosis with no underlying stenosis, resulting in substantial myocardial injury. A previously well 32-year-old man presented with chest pain which commenced 24 h after intranasal cocaine use. He denied use …