Citation

Esposito M, Liberto A, Zuccarello P, Ministeri F, Licciardello G, Barbera N, Sessa F, Salerno M. Leg. Med. (Elsevier) 2022; 58: e102084.

Copyright

(Copyright © 2022, Japanese Society of Legal Medicine, Publisher Elsevier Publishing)

DOI

10.1016/j.legalmed.2022.102084

PMID

35561504

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.

Language: en

Keywords

Sudden death; Forensic toxicology; Forensic pathology; Cardiac tamponade; Cocaine intoxication; Hearth rupture