← all scenarios

medical emergency

Severe Chest Pain or Racing Heart

When When pressing chest pain, tightness, shortness of breath, or a racing heart over 150/min occur after stimulant use (cocaine, amphetamines, MDMA, cathinones).

review pending

Content is undergoing medical and legal review. Changes possible.

Emergency

Call 112. Calling for help is required by law (German Criminal Code § 323c). levelll cannot promise immunity from criminal or administrative consequences.

Immediate

  1. 1. Call 112 — suspected heart attack or acute arrhythmia.
  2. 2. Sit the person down with their upper body raised, calm them, minimize movement.
  3. 3. No further stimulants. If available and the person is not unconscious: 1 glass of water for a dry mouth, nothing else.

Don't do

  • Do not lay the person down if they breathe more comfortably sitting upright.
  • No ‚calming' with alcohol or sedatives without medical instruction.
  • Do not drive to the clinic by car — an emergency doctor with an ECG arrives faster and more safely.

Stimulants — especially cocaine — are an established cause of heart attacks in young people. Mechanisms:

  • Vasoconstriction of the coronary arteries
  • Tachycardia + hypertension increase oxygen demand
  • Acute plaque rupture possible with pre-existing strain
  • With alcohol: cocaethylene amplifies cardiac toxicity

When there is a suspicion, an ECG in the ambulance is the fastest diagnostic step. Even if the symptoms ease off: get medical assessment the same day, because delayed complications (arrhythmias, myocarditis) are documented.

People with known heart problems or a family history of sudden cardiac death: stimulant use is not something that can be controlled „with caution”.