Legal Medicine, Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, 95123 Catania, Italy.
Department G.F. Ingrassia, Laboratory of Forensic Toxicology, University of Catania, 95123 Catania, Italy.
Leg Med (Tokyo). 2022 Sep;58:102084. doi: 10.1016/j.legalmed.2022.102084. Epub 2022 May 2.
The purpose of this study is to show a very rare complication of acute cocaine poisoning, namely heart rupture. In the present case report, acute cocaine intoxication caused massive myocardial infarction, resulting in heart rupture and cardiac tamponade. A crime scene investigation found a dead body on the street in a drug dealing district. Examination of the body showed no external injuries. A thorough autopsy was performed showing massive cardiac tamponade with 510 ml of blood within the pericardium and full-thickness tissue lesion at the posterior wall of the left ventricle of 3.5 × 3 cm. Histological examination in hematoxylin and eosin was performed and confirmed the interruption of the posterior wall of the left ventricle with the presence of blood. In fact, although the correlation between cocaine and myocardial damage is well established, the relationship between heart rupture and acute cocaine intoxication is an extremely rare event. Moreover, since there are, to date, few reports of similar deaths, our report provides useful information regarding sudden death in a cocaine abuser. It is, therefore, of crucial importance to report this case to the scientific community.
本研究旨在展示急性可卡因中毒的一种非常罕见的并发症，即心脏破裂。在本病例报告中，急性可卡因中毒导致大面积心肌梗死，进而引发心脏破裂和心脏压塞。现场勘查在毒品交易区的街道上发现了一具尸体。尸检未发现外部损伤。进行了彻底的尸检，显示心包内有 510 毫升血液的大量心脏压塞，左心室后壁有 3.5×3 厘米的全层组织损伤。进行了苏木精和伊红的组织学检查，证实了左心室后壁的中断，并存在血液。事实上，尽管可卡因与心肌损伤之间的相关性已得到充分证实，但心脏破裂与急性可卡因中毒之间的关系是一种极其罕见的事件。此外，由于迄今为止类似死亡的报告很少，因此我们的报告提供了有关可卡因滥用者猝死的有用信息。因此，向科学界报告这一案例至关重要。
