Cocaine use can cause serious damage to the heart and cardiovascular system. Cocaine can cause blood vessels to constrict, leading to decreased blood flow to the heart, which can cause a heart attack. Cocaine can also cause arrhythmias (irregular heartbeats), which can lead to cardiac arrest and death. Additionally, cocaine use can lead to increased blood pressure, which can cause aortic dissection (a tear in the wall of the major blood vessel that carries blood away from the heart), and stroke.