Basilicata Pascale, Lombardi Antonio, Marisei Mariagrazia, Capasso Emanuele, Simonelli Angela, Pieri Maria
Department of Advanced Biomedical Sciences, School of Medicine, University of Naples Federico II, Via S. Pansini, 5, Naples, 80131, Italy.
Legal Medicine Division, Local Health Authority (ASL) Napoli2Nord, Naples, Italy.
Forensic Sci Med Pathol. 2025 Jan 23. doi: 10.1007/s12024-025-00951-7.
The dissection of the aorta is a serious and potentially fatal consequence of cocaine use. Nonetheless, the underlying mechanisms and characteristics of this phenomenon remain to be deeply studied. The autopsy case of a 46-year-old white male found irresponsive and unconscious in his house and had a history of abusing cocaine is presented. Autopsy findings showed aortic arch and thoracic aorta of regular calibre, with evidence of a mid-adventitial dissecting aneurysm of the ascending intrapericardial portion of the aorta. Forensic toxicological analyses evidenced a positivity to cocaine and its main metabolite, benzoylecgonine, in all fluids (peripheral blood, bile and urine), liver and brain homogenates. Data also evidenced a positivity to alcohol, confirming a past history of intake. The presented case confirms the connection between cocaine addiction and the risk of aortic dissection, emphasizing the need for increased knowledge about the risks connected to this drug. It is emphasized the need of prompt examination and effective treatment of patients exhibiting cardiac symptoms linked to cocaine use, as well as the need of an accurate anamnesis to evidence use/abuse of other cardiotoxic substances.
主动脉夹层是使用可卡因的一种严重且可能致命的后果。尽管如此，这一现象的潜在机制和特征仍有待深入研究。本文介绍了一名46岁白人男性的尸检案例，该男性在家中被发现无反应且昏迷，有可卡因滥用史。尸检结果显示主动脉弓和胸主动脉管径正常，但有证据表明升主动脉心包内部分中膜外膜有夹层动脉瘤。法医毒理学分析表明，在所有体液（外周血、胆汁和尿液）、肝脏和脑组织匀浆中，可卡因及其主要代谢物苯甲酰爱康宁呈阳性。数据还表明酒精呈阳性，证实了过去有饮酒史。该案例证实了可卡因成瘾与主动脉夹层风险之间的联系，强调了增加对与该药物相关风险认识的必要性。强调了对出现与使用可卡因相关心脏症状的患者进行及时检查和有效治疗的必要性，以及通过准确的问诊来证明是否使用/滥用其他心脏毒性物质的必要性。
