Study on Forms of Intoxication with Cocaine and Evolutionary Aspects

Abstract

Cocaine is an alkaloid obtained from the leaves of the coca plant, Erythroxylum coca. Cocaine sulfate, a brown paste, is obtained from coca leaves and from this, cocaine hydrochloride, a white substance, soluble in water and with a bitter taste that may be in the form of white crystals or powder. From cocaine hydrochloride crack is obtained by heating, a more purified form and with greater power of intoxication and addiction. Once in the organism, cocaine behaves like an indirect sympathomimetic amine and produces a blockade of the presynaptic reuptake of dopamine, adrenaline, noradrenaline and serotonin, thus increasing their levels. At the cardiovascular level cocaine is responsible for malignant arrhythmias, sometimes responsible for sudden death. Other symptoms that can occur are aortic dissection, arterial hypertension and coronary vasoconstriction able to trigger an acute myocardial infarction. The authors present a case of sudden cardiac death due to cocaine intoxication in a young male without any cardiac risk factors. The autopsy, together with the results of the complementary tests, indicate that the most probable death mechanism has been a cardiogenic shock secondary to extensive myocardial necrosis due to cocaine intoxication.