Sudden death of a cocaine abuser

We report an autopsy case of a 28-year-old male who died after intravenous use of cocaine. Cocaine and ecgonine methyl ester, the major metabolite of cocaine, were detected in the blood with gas chromatography/mass spectrometry. Postmortem examination showed contraction band necrosis together with patchy fibrosis and inflammatory cell infiltration in the heart. The sudden death appeared to be caused by a cardiac disorder associated with arrhythmia or coronary vasoconstriction.