Cocaine toxicity

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Cocaine toxicity is seen in by pathologists in the forensic setting.

General

  • Anatomical findings at autopsy are uncommon (most common situation) or non-specific (atherosclerosis +/- acute thrombosis).[1]
  • Toxicity mechanisms:
    • Direct effects of norepinephrine on myocytes
    • Vasospasm leading to myocardial ischemia.

Gross pathology

Features (heart):[2]

  • +/-Atherosclerosis out of keeping with age.
  • +/-Large areas of confluent necrosis.
  • +/-Fibrosis.

Microscopic

Features (heart):[2]

  • +/-Large areas of confluent necrosis.
  • +/-Contraction band necrosis.
  • +/-Fibrosis.
  • +/-Myocarditis (usu. eosinophilic).

See also

References

  1. ↑ Virmani R (1991). "Cocaine-associated cardiovascular disease: clinical and pathological aspects". NIDA Res. Monogr. 108: 220–9. PMID 1749414.
  2. ↑ 2.0 2.1 Kloner RA, Hale S, Alker K, Rezkalla S (February 1992). "The effects of acute and chronic cocaine use on the heart". Circulation 85 (2): 407–19. PMID 1346509. http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=1346509.
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