Mittleman R E, Wetli C V
J Forensic Sci. 1987 Jan;32(1):11-9.
The cardiovascular effects of cocaine may culminate in clinical episodes of angina pectoris, myocardial infarction, arrhythmias, and intracranial hemorrhage. To clarify whether or not cocaine causes fatalities by these mechanisms, we studied 24 cases of sudden, apparently natural deaths as a result of coronary arteriosclerosis (15 cases), hypertensive cardiovascular disease (4 cases), and intracranial hemorrhage (5 cases) associated with cocaine use. In 11 cases, cocaine was found in the blood (average concentration: 0.57 mg/L, range: 0.05 to 1.45 mg/L), whereas in the remainder, cocaine or its major metabolite was found in the urine or other tissues. In the majority of decedents, autopsy disclosed the existence of severe natural disease which could have been exacerbated by the administration of stimulant drugs, including cocaine. These data, and a review of the current medical literature, indicate that cocaine may precipitate the sudden death of an individual with undiagnosed cardiovascular disease. A contributory role of cocaine should be considered in any apparently natural death occurring in a population where cocaine abuse is prevalent.
可卡因对心血管系统的影响可能最终导致心绞痛、心肌梗死、心律失常和颅内出血等临床症状。为了明确可卡因是否通过这些机制导致死亡，我们研究了24例因冠状动脉粥样硬化（15例）、高血压性心血管疾病（4例）和与使用可卡因相关的颅内出血（5例）而突然发生的、看似自然死亡的病例。在11例病例中，血液中检测到可卡因（平均浓度：0.57毫克/升，范围：0.05至1.45毫克/升），而在其余病例中，尿液或其他组织中检测到可卡因或其主要代谢产物。在大多数死者中，尸检发现存在严重的自然疾病，使用包括可卡因在内的兴奋剂药物可能会使其病情加重。这些数据以及对当前医学文献的回顾表明，可卡因可能会促使患有未被诊断出的心血管疾病的个体突然死亡。在可卡因滥用盛行的人群中发生的任何看似自然的死亡事件中，都应考虑可卡因的促成作用。
