Morphologische kardiale Veränderungen bei Drogentoten

Drug-associated pathological changes in the heart as direct or indirect consequences of drug abuse are the result of diverse triggers. How extensive the degree of damage is and which substances are capable of causing specific pathological changes of the heart is often difficult to determine.

The aim of this study was to investigate the degree of expression and the type of cardiac damage in drug deaths. Moreover, another aspect was to investigate if a relation exists between the profile or the intensity of drug consumption and the cardiac pathologies.

A total of 136 cases of drug deaths in the years 2013 and 2014 were examined morphologically and histologically regarding the pathological changes of the heart. Based on the toxicological examination the proof that drug abuse had taken place was provided. Furthermore, the deceased drug users were divided into groups of consumption profiles and consumption intensity. Finally, statistical analyses were carried out to uncover potential relations between specific substances and cardiac findings.

A total of 70 deceased with an average age of 40 years showed cardiac findings. Frequent cardiac findings were heart attacks, dilated and hypertrophic cardiomyopathies. While in 38 cases the findings could be explained by a cardiac-relevant previous illness, there were 32 cases without a relevant illness that could have explained the pathological changes in the heart. In these cases, the assumption had to be made that drug abuse has a significant impact on the development of the illness. The final comparison of the consumption groups could not only point out the special role of cocaine in developing a cardiac disease. It could additionally be shown that drug users consuming stimulants presented the same prevalence of cardiac findings but were significantly younger.

Cardiac findings are found more frequently in the group of drug addicts. There is important circumstantial evidence for the cardiotoxic effects of drugs in general and in particular for cocaine. Additional examinations at a genetic and cellular level have to be done to reveal more insights especially into drug users with polytoxicomania. As a conclusion of these results cardiological care is strongly recommended for such addicts.