Rajs J, Falconer B
Forensic Sci Int. 1979 May-Jun;13(3):193-209. doi: 10.1016/0379-0738(79)90288-3.
Postmortem findings in 25 intravenous addicts of centrally stimulating amines and centrally depressive narcotics (opiates) have been analysed with special reference to the presence of pathologic findings in the heart, and the cause of death. Most cases exhibited myocardial lesions of varying age, consistent with various phases of myofibrillar degeneration, such as hemorrhages, contraction bands, focal necroses, granulation tissue, stromal condensation, and scarring, indicating an active chronic process in the myocardium and the subendocardium, with a bias toward the conduction system of the heart. The lesions have been found in drug addicts who died immediately following an injection of narcotics as well as in those who, irrespective of their drug influence, have died following intervening injuries or disease. Cardiac lesions in drug addicts seem to have a variety of causative factors: infections, toxic influence, hypersensitivity, influence of catecholamines and general hypoxia. The authors feel that the two latter suggested causes appear most regularly and deserve special attention. The significance of these heart lesions seems to vary, but at times they may be the determining factor in the fatal outcome of a case.
对25名静脉注射中枢兴奋剂和中枢抑制剂（阿片类）的吸毒者的尸检结果进行了分析，特别关注心脏的病理发现及死因。大多数病例呈现出不同时期的心肌病变，与肌原纤维变性的各个阶段相符，如出血、收缩带、局灶性坏死、肉芽组织、间质浓缩和瘢痕形成，表明心肌和心内膜下层存在活跃的慢性病变，且偏向于心脏传导系统。这些病变在注射麻醉品后立即死亡的吸毒者中被发现，也在那些无论是否受药物影响，在遭受外伤或疾病后死亡的吸毒者中被发现。吸毒者的心脏病变似乎有多种致病因素：感染、毒性影响、超敏反应、儿茶酚胺的影响和全身性缺氧。作者认为，后两种推测的病因出现最为频繁，值得特别关注。这些心脏病变的意义似乎各不相同，但有时它们可能是病例致命结局的决定性因素。
