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Related Experiment Videos

Cocaine and the heart.

H D Tazelaar, S B Karch, B G Stephens

    Human Pathology
    |February 1, 1987
    PubMed
    Summary

    Cocaine use is linked to significant heart damage, particularly myocardial contraction bands. These bands, more prevalent in cocaine-related deaths, may explain arrhythmias and serve as forensic markers for overdose.

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    Area of Science:

    • Cardiovascular Pathology
    • Forensic Toxicology

    Background:

    • Cocaine use is associated with severe cardiac adverse effects, including angina, myocardial infarction, and sudden death.
    • Actual myocardial pathology reports are limited, necessitating further investigation into cocaine-associated cardiotoxicity.

    Purpose of the Study:

    • To clarify the pathophysiology of cocaine-associated cardiotoxicity.
    • To identify potential forensic markers in cocaine-related deaths.

    Main Methods:

    • Microscopic examination of random heart sections from 30 cocaine-associated deaths.
    • Comparison with 20 control cases of sedative-hypnotic overdose deaths.
    • Correlation of myocardial findings with cocaine levels and other drug screening results.

    Main Results:

    • Myocardial contraction bands were present in 93% of cocaine-associated deaths, significantly more than in controls (P < .001).
    • The prevalence of contraction bands correlated with cocaine levels.
    • Contraction band presence was independent of other drugs, number of sections examined, or resuscitation history.

    Conclusions:

    • Myocardial contraction bands are a significant finding in cocaine-associated cardiotoxicity.
    • These bands may represent the substrate for cocaine-induced arrhythmias.
    • Contraction bands can serve as a morphologic marker for lethal cocaine overdose and unexpected deaths with positive cocaine screens.

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