Heart rupture as an acute complication of cocaine abuse: A case report |
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| Institution: | 1. Legal Medicine, Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, 95123 Catania, Italy;2. Department G.F. Ingrassia, Laboratory of Forensic Toxicology, University of Catania, 95123 Catania, Italy;3. Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;1. Research and Education Faculty, Medical Sciences Cluster, Health Service Center, Kochi University, Kochi, Japan;2. National Research Institute of Police Science, Chiba, Japan;1. Department of Anatomy, Catholic Institute for Applied Anatomy, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Republic of Korea;2. Division of Forensic Odontology and Disaster Oral Medicine, Department of Forensic Science, Iwate Medical University, 1-1-1, Idaidori, Yahaba-cho, Shiwa-gun, Iwate 028-3694, Japan;1. Sección de Antropología y Odontología Forense, Instituto de Medicina Legal, Madrid, Spain;2. Escuela de Medicina Legal, Universidad Complutense, Madrid, Spain;3. Instituto de Medicina Legal, Madrid, Spain;4. Departamento de Cirugía, Ciencias Médicas y Sociales, Universidad de Alcalá, Madrid, Spain;1. CHU Poitiers, service de médecine légale, CS 90577 86020 Poitiers Cedex, France;2. Univ Poitiers, faculté de médecine et de pharmacie, 6 rue de la Milétrie TSA, 51115 86073 Poitiers Cedex 9, France;1. First Department of Forensic Science, National Research Institute of Police Science, 6-3-1 Kashiwanoha, Kashiwa, Chiba 277-0882, Japan;2. Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Nishi 15, Kita 7, Sapporo, Hokkaido 060-8638, Japan;3. Department of Forensic Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan;1. Department of Legal Medicine, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahikawa, Hokkaido 078-8510, Japan;2. Department of Forensic Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan;3. Division of Tumor Pathology, Department of Pathology, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahikawa, Hokkaido 078-8510, Japan;4. Department of Forensic Medicine, School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita 286-8686, Japan |
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| Abstract: | 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. |
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| Keywords: | Forensic pathology Forensic toxicology Cocaine intoxication Hearth rupture Cardiac tamponade Sudden death |
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