Cocaine-associated chest pain is a commonly encountered emergency. This art
icle reviews the pathology and describes a management plan that will allow
emergency physicians to provide appropriate care to patients with cocaine-a
ssociated chest pain. A combination of clinical criteria with a 12-hour obs
ervation period can be used to identify most patients at risk for complicat
ions. For the majority of patients with cocaine-associated pain, however, a
plan consisting of outpatient evaluation with dynamic testing and cocaine
detoxification will usually suffice.