Cocaine in sudden and unexpected death: a review of 49 post-mortem cases.

摘要: Cocaine is a potent sympathomimetic drug that associated with cardiotoxicity, including ventricular arrhythmia, systemic hypertension, acute myocardial infarction and left hypertrophy. The use of cocaine in Australia has risen steadily since the late 1990s. What remains unclear literature whether cocaine-associated death can occur absence other contributing factors, such as concomitant or natural disease. A search was conducted on National Coroners Information System database, to identify all deaths occurring Victoria, Australia, between January 2000 December 2011, where its metabolites were detected by post-mortem toxicological analysis. All cases closed Coroner. These examined regards case circumstances, pathology toxicology results, coronial findings, determine prevalence cardiotoxicity involvement compared factors. There 49 cocaine, benzoylecgonine, ecgonine methyl ester, methylecgonine cocaethylene, 11-year period. individuals ranged age from 16 70 years (median 30). 36 males. In 22 cause determined be toxicity, external injury 5 attributed concentration relatively low (range 0.01-3 mg/L, median 0.1 mg/L). frequently blood urine: benzoylecgonine (46 cases); ester (12 cocaethylene (8 (9 cases). Opioids commonly (23 cases), addition amphetamines (15 ethanol (17 cases) benzodiazepines Of 43 receiving full autopsy, there 14 involving significant heart This included coronary artery disease (11 an enlarged (5 myocarditis contraction band necrosis. infrequently Victorian cases. However it appears degree particularly hypertrophy, independent concentration.