Physicians say decades of drug and alcohol use may have contributed to the death of Star Wars actress Carrie Fisher from a heart attack at the age of 60.

Fisher, who died Tuesday, once said she used so much cocaine that John Belushi -- killed by an overdose -- had warned her to stop. She also drank heavily, used marijuana from age 13 and abused the prescription opioid oxycodone.

Dr. Sophie Gosselin, an emergency room physician and associate professor at McGill University in Montreal, says all of the drugs Fisher used can do damage to the heart -- particularly cocaine.

Dr. Gosselin said cocaine and other stimulants “constrict the arteries, preventing blood flow and causing mini heart attacks.”

“Cocaine ages a heart, with regular use, much faster than normal aging,” according to Dr. Gosselin. “People who are using and abusing cocaine or similar stimulant drugs can have a heart 10 years older than (their) age.”

In fact, cocaine can be dangerous even if used only once, according to Dr. Gosselin. “We’ve seen plenty of cocaine-induced heart attacks (and) strokes,” she said.

When it comes to alcohol, moderation is important, according to Dr. Gosselin. Drinking too much can cause a condition called alcoholic cardiomyopathy, which is a dangerous enlargement of the heart.

To reduce the long-term health risks, women should not drink more than two standard drinks per day or 10 per week and men should not have more than three per day or 15 per week, according to the Canadian Guidelines for Low Risk Drinking.

Opioids like oxycodone and fentanyl can also lead to heart attacks when they cause users to stop breathing, according to Dr. Gosselin.

And she points out that cannabis, which raises the heart rate, is increasingly linked to heart problems.

Dr. Mitch Shulman, who is also an emergency room physician and medicine instructor at McGill, says a number of other factors can contribute to heart attacks, including activity level, cholesterol and blood pressure.

Dr. Shulman says everyone should be aware of the symptoms of a heart attack, which can include pain in the neck, jaw, arms or chest -- although sometimes no pain is reported.

Symptoms can also include sudden weakness, nausea, shortness of breath and light-headedness, according to Dr. Shulman.

He says everyone should learn CPR so that they might save a person experiencing a cardiac arrest. “Most of the population,” he says, “wouldn’t know what to do.”

With a report from CTV Montreal’s Cindy Sherwin