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Case Reports in Medicine
Volume 2011 (2011), Article ID 174132, 4 pages
http://dx.doi.org/10.1155/2011/174132
Case Report

Dexmedetomidine Use in the Setting of Cocaine-Induced Hypertensive Emergency and Aortic Dissection: A Novel Indication

Division of Cardiology, St. Luke's Roosevelt Hospital Center, University Hospital for College of Physicians and Surgeons of Columbia University, 1090 Amsterdam Avenue, New York, NY 10025, USA

Received 1 September 2010; Revised 17 May 2011; Accepted 14 June 2011

Academic Editor: Jagdish Butany

Copyright © 2011 Fahad Javed et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aortic dissection is a potentially fatal but rare disease characterized by an aortic intimal tear with blood passing into the media creating a false lumen and with resultant high mortality depending on the location of dissection if not aggressively treated. Cocaine users are known to have a higher incidence of aortic dissection. We report here aortic dissection in a patient with cocaine abuse which did not respond to traditional medication regimes used currently in this setting. Worth mentioning is the use of an alpha-2 receptor selective agonist named Dexmedetomidine as a treatment modality to control hypertension in this patient, which is approved only for sedation of intubated and mechanically ventilated patients in the intensive care settings and for sedation during invasive procedures. This paper illustrates the practical beneficial role of Dexmedetomidine in controling blood pressure in the settings of cocaine-induced sympathetic surge when other treatment modalities fail.