title: Myocardial damage and rhabdomyolysis associated with prolonged hypoxic coma following opiate overdose.
abstract: We report a case of biopsy proven myocardial damage after opiate-induced rhabdomyolysis. Myocardial biopsy showed focal lesions formed by small mononuclear inflammatory cells with a few neutrophils, associated with degenerated and necrotic myocardial fibers, interstitial edema and congestion of intrinsic blood vessels. These findings were similar to those seen with other drug overdoses if combined with strenuous muscular effort or hypoxic coma. We hypothesize that myocardial damage is a consequence of intracapillary myohypoxia associated with prolonged hypoxic coma following opiate overdose.
authors.affiliation: Servizio e Cattedra di Medicina d'Urgenza, University of Bologna, Italy
authors.forename: R
authors.initials: R
authors.lastname: Melandri
authors.forename: G
authors.initials: G
authors.lastname: Re
authors.forename: C
authors.initials: C
authors.lastname: Lanzarini
authors.forename: C
authors.initials: C
authors.lastname: Rapezzi
authors.forename: O
authors.initials: O
authors.lastname: Leone
authors.forename: I
authors.initials: I
authors.lastname: Zele
authors.forename: G
authors.initials: G
authors.lastname: Rocchi
mesh_terms: D000328:Adult; D001706:Biopsy; D009202:Cardiomyopathies / Q000139:chemically induced* / Q000473:pathology; D015687:Cell Hypoxia; D003128:Coma / Q000139:chemically induced*; D062787:Drug Overdose; D006321:Heart / Q000187:drug effects; D003932:Heroin / Q000506:poisoning*; D006801:Humans; D008297:Male; D009206:Myocardium / Q000473:pathology*; D009294:Narcotics / Q000506:poisoning*; D009336:Necrosis; D012206:Rhabdomyolysis / Q000139:chemically induced* / Q000473:pathology
chemical_list: D009294:Narcotics; D003932:Heroin