title: Cannabis and cocaine: a lethal cocktail triggering coronary sudden death.
abstract: The case of a 31-year-old man who died suddenly, with a history of drug abuse and no risk factors for coronary artery disease, is herein reported. Postmortem examination disclosed critical stenosis due to a fibrocellular atherosclerotic plaque complicated by occlusive thrombosis at the level of the left anterior descending coronary artery. Chemico-toxicological analysis revealed high levels of cocaine, tetrahydrocannabinol, and metabolites. When dealing with an acute coronary syndrome in young people, with or without a history of drug abuse, toxicological examination should always be performed to rule out unnatural causes of myocardial ischemia.
authors.affiliation: Forensic Medicine, Department of Medico-Diagnostic Sciences and Special Therapies, University of Padua Medical School, Padua, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Montisci
authors.forename: Gaetano
authors.initials: G
authors.lastname: Thiene
authors.forename: Santo Davide
authors.initials: SD
authors.lastname: Ferrara
authors.forename: Cristina
authors.initials: C
authors.lastname: Basso
mesh_terms: D000328:Adult; D002188:Cannabis / Q000009:adverse effects*; D003042:Cocaine / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000150:complications; D023921:Coronary Stenosis / Q000209:etiology; D016757:Death, Sudden, Cardiac / Q000209:etiology*; D018765:Dopamine Uptake Inhibitors / Q000009:adverse effects*; D006801:Humans; D008297:Male; D019966:Substance-Related Disorders / Q000503:physiopathology*
chemical_list: D018765:Dopamine Uptake Inhibitors; D003042:Cocaine