Jacobs Werner
Department of Forensic Pathology, University Hospital Antwerp, Edegem, Belgium.
Am J Forensic Med Pathol. 2006 Jun;27(2):156-60. doi: 10.1097/01.paf.0000188082.68009.10.
Amphetamines are popular drugs of abuse, particularly among youngsters and at dance scenes. Cardiotoxicity (manifested as cardiomyopathy, acute myocardial infarction/necrosis, heart failure, or arrhythmia) after the recreational (mis)use of amphetamine and its synthetic derivatives has been documented but is rather rare. Amphetamine-related cardiac fatalities are even more rare. We present 6 cases of young persons who died unexpected after the chronic abuse of amphetamines. Death was not attributed to a lethal intoxication but to an acute myocardial necrosis, a right ventricle rupture, a cardiomyopathy, or an arrhythmia. Two of the deceased persons presented prior to their death to the emergency department, but their complaints were not considered (probably due to their young age) to be of cardiac origin. One case was a sport-related fatality where medical screening failed to identify the underlying cardiac pathology or the amphetamine abuse, and 1 case was a so-called idiopathic dilated cardiomyopathy where substance abuse was not considered by the treating physician. We think that amphetamine-associated cardiotoxicity is a rare but probably genuine entity that should be considered both in forensic and clinical/emergency medicine because of its potential medicolegal implications.
苯丙胺类药物是常见的滥用药物，尤其在年轻人和舞会场合中。苯丙胺及其合成衍生物在娱乐性（误）用后出现心脏毒性（表现为心肌病、急性心肌梗死/坏死、心力衰竭或心律失常）的情况已有记录，但相当罕见。与苯丙胺相关的心脏死亡更为罕见。我们报告6例长期滥用苯丙胺后意外死亡的年轻人病例。死亡并非归因于致命中毒，而是急性心肌坏死、右心室破裂、心肌病或心律失常。其中两名死者在死前曾前往急诊科就诊，但他们的症状未被认为（可能因其年轻）与心脏有关。1例与运动相关的死亡病例中，医学筛查未能识别出潜在的心脏病变或苯丙胺滥用情况，还有1例是所谓的特发性扩张型心肌病，治疗医生未考虑到药物滥用因素。我们认为，苯丙胺相关的心脏毒性是一种罕见但可能确实存在的情况，鉴于其潜在的法医学意义，在法医学以及临床/急诊医学中均应予以考虑。
