Which substance of abuse is most commonly associated with causing myocardial ischemia?

• A. Cocaine
• B. LSD
• C. Alcohol
• D. Cannabis

Answer: (A)

Verified step by step guidance

1. Understand the term 'myocardial ischemia': It refers to a condition where there is reduced blood flow to the heart muscle, often caused by blockages or spasms in the coronary arteries. This can lead to chest pain (angina) or even a heart attack.
2. Review the physiological effects of each substance listed: Cocaine, LSD, Alcohol, and Cannabis. Focus on how each substance interacts with the cardiovascular system.
3. Analyze the effects of cocaine: Cocaine is a powerful stimulant that can cause vasoconstriction (narrowing of blood vessels), leading to reduced blood flow to the heart. This makes it a strong candidate for causing myocardial ischemia.
4. Compare the effects of the other substances: LSD primarily affects the central nervous system and is less associated with direct cardiovascular effects like myocardial ischemia. Alcohol, in moderate amounts, may have some cardiovascular benefits, but excessive use can lead to long-term heart damage rather than acute ischemia. Cannabis has mixed effects on the cardiovascular system but is less commonly linked to myocardial ischemia compared to cocaine.
5. Conclude that cocaine is the substance most commonly associated with causing myocardial ischemia due to its potent vasoconstrictive effects on coronary arteries, which can significantly reduce blood flow to the heart muscle.