|
Case 1: JF is a 42-year old previously healthy farmer who presented with sudden onset central chest pain of one hour duration to the ED. The pain is associated with sweating and radiates to the left arm and jaw. The area of discomfort is about the size of the fist. |
Ragavendra
R. Baliga, M.D
Assistant
Professor
Division
of Cardiology
University
Of Michigan
Question 21 of 39:
As this patient used to be a regular coffee drinker (~4 cups of coffee per day) he should avoid coffee while in the CCU.
You clicked 'True'
Incorrect!
Routine caffeine drinkers can safely drink several cups of coffee daily even while in CCU [1]. People who drink caffeinated beverages regularly develop a tolerance after 1 to 4 days [2,3], regardless of the dose. Withdrawal of coffee is associated with headache and increases in heart rate [4]. Blood pressure increases after caffeine intake, but the increase is not clinically significant until 400 mg of caffeine (ie, 2 to 4 cups of coffee, depending on the strength and brewing method) is ingested.
Reference:
1. Lynn LA, Kissinger JF. Coronary precautions: should caffeine be restricted in patients after myocardial infarction. Heart Lung 1992;21:365-371.
2. Myers MG, Harris L, Leenen FH, Grant DM. Caffeine as a possible cause of ventricular arrhthmias during the healing phase of acute myocardial infarction. Am J Cardiol 1987;59:1024-1028.
3. Pincomb GA, Lovallo WR, Passey RB, Whitsett TL, Silverstein SM, Wilson MF. Effects of caffeine on vascular resistance, cardiac output and myocardial contractility in young men. Am J Cardiol 1985;56:119-122.
4. van Dusseldorp M, Katan MB. Headache caused by caffeine withdrawal among moderate coffee drinkers switched from ordinary to decaffeinated coffee: a 12 week double blind trial. BMJ 1990;300:1558-1559.
Copyright 2001 by the University of Michigan Board of Regents. All rights reserved.