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[Morphological and toxicological findings after intravenous injection of metallic mercury]
H T Haffner1, J Erdelkamp, E Göller
1Institut für Gerichtliche Medizin, Universität Tübingen.
Abstract:
At the autopsy of a 25-year-old man who had died from combined morphine and cocaine intoxication, depositions of metallic mercury were incidentally found in the myocardium of the right ventricular septum and posterior wall. Deposits, toxicologically identified as mercury, were also found radiologically and histologically in the lungs. All these deposits were probably the result of intravenous injections of mercury many months previously, as is known to be done occasionally by addicts. Judging by the histological picture the greatest proportion of the mercury collected in the right ventricular cavity after injection, a smaller amount by embolization in the small pulmonary arteries. The mercury spheres which came to lie in the right ventricle then penetrated into the myocardium, moving outward and causing a chronic and partly transmural inflammatory response.
Insights
Metallic mercury deposits were incidentally found in the heart and lungs of a young man following intravenous injections. These deposits caused chronic inflammation in the heart muscle.
Area of Science:
- Toxicology
- Cardiovascular Pathology
- Forensic Medicine
Background:
- Intravenous drug abuse can involve non-pharmaceutical substances.
- Metallic mercury injections are a rare but documented practice among some substance abusers.
- Understanding the deposition and effects of embolized mercury is crucial for forensic and clinical toxicology.
Observation:
- Autopsy revealed metallic mercury deposits in the myocardium (right ventricular septum and posterior wall) and lungs.
- Radiological and histological examination confirmed mercury presence.
- The patient had a history of combined morphine and cocaine intoxication.
Findings:
- Mercury deposits likely resulted from intravenous injections months prior.
- Histology suggested mercury initially collected in the right ventricle, with some embolizing to pulmonary arteries.
- Mercury spheres penetrated the myocardium, inducing a chronic, partly transmural inflammatory response.
Implications:
- This case highlights a rare route of heavy metal exposure in intravenous drug users.
- The findings illustrate the potential for metallic mercury emboli to cause cardiac and pulmonary pathology.
- Forensic analysis should consider mercury embolization in cases of unexplained cardiac inflammation or pulmonary findings in potential drug users.