For patients with a suspected heart attack, doctors need to rule out cocaine use because exposure to the drug can affect their treatment, committee chair Dr. James McCord, cardiology director of the chest pain unit of the Henry Ford Medical System in Detroit, said in a prepared statement. He noted that two standard heart attack treatments -- beta-blockers and clot-busting drugs -- can be dangerous if a patient has been using cocaine.

Increased blood pressure due to recent cocaine use can increase the risk of bleeding into the brain when a patient is given clot-busting drugs, the experts explained. Normally, beta-blockers can lower blood pressure without constricting the arteries of typical heart attack patients. But beta-blockers can have the opposite effects -- higher blood pressure and constricted arteries -- in people who've used cocaine.

While research shows that cocaine-related chest pain tends to occur within three hours of using the drug, the chemical remnants of cocaine can remain in the body for at least 18 hours and continue to cause problems, said McCord, who noted that between 1999 and 2002, cocaine-related emergency department visits increased by 47 percent. People ages 35-44 account for 37 percent of all cocaine-related visits to emergency departments, he added.

Since most cocaine-associated chest pain is not a heart attack, cocaine users with chest pain should be monitored in an observation unit for nine to 12 hours, the statement recommends.

"If the patients are alert and can talk to you, typically you want to tell them, 'Look, it is important for us to know if you are taking cocaine because it could change the way we treat you,'" McCord said. "If a patient is unconscious, a drug test could be done at the physician's discretion."

While patients are in an observation unit, there's also an opportunity for healthcare