Cocaine-induced acute aortic dissection.

While cocaine-induced myocardial infarction has been frequently documented, the differential diagnosis of chest pain should include aortic pathology. The successful management of acute aortic dissection secondary to cocaine abuse has not been previously reported to our knowledge. In a 45-year-old man who presented with typical chest pain and wide mediastinum, the successful management of this disease included early and accurate diagnosis and replacement of the aortic valve as well as the torn portion of the ascending aorta.