What is the recommended treatment for cocaine-induced chest pain?

The recommended treatment for cocaine-induced chest pain primarily focuses on managing the symptoms and addressing the underlying cardiovascular effects caused by cocaine use. In this scenario, benzodiazepines are considered the most appropriate initial management for several reasons.

Cocaine can lead to significant anxiety and sympathetic nervous system activation, which can exacerbate chest pain due to increased heart rate and elevated blood pressure. Benzodiazepines help to reduce anxiety and provide sedation, which can alleviate distress and contribute positively to the management of chest pain. Additionally, they may help reduce adrenergic overactivity and allow for better cardiovascular stabilization.

While nitroglycerin is commonly used for chest pain due to angina or myocardial ischemia, it must be approached cautiously in the setting of cocaine-induced chest pain as it can drop blood pressure, which can be problematic if the patient has accompanying hypotension or has consumed other substances that might also lead to hemodynamic instability.

Opioids can provide pain relief but do not specifically address the benzodiazepine-mediated anxiety and may also have the potential to increase sedation in patients who may be presenting with altered mental status due to cocaine effects.

Aspirin is useful in managing chest pain associated with myocardial infarction but does not directly address the immediate symptoms of