Cocaine-Induced Cardiomyopathy as a Rare Etiology of Severe Heart Failure in Young Adults: A Case Report

Cocaine use is well known to cause acute cardiovascular events, but chronic cardiomyopathy is a less common consequence. We present a 27-year-old male with five years of cocaine use who developed acute decompensated heart failure, marked by severe biventricular dilation, an ejection fraction of 19%, pulmonary hypertension, and multiorgan congestion. After inpatient stabilization, he was started on guideline-directed medical therapy and abstained from cocaine. This case underscores that even profound cardiac dysfunction from cocaine can be substantially reversible with early recognition, aggressive therapy, and substance cessation.