Sudden Unexpected Death of a Methamphetamine Abuser with Cardiopulmonary Abnormalities
Sudden Unexpected Death of a Methamphetamine Abuser with Cardiopulmonary Abnormalities
复制标题
一名心肺异常的甲基苯丙胺滥用者意外猝死
DOI：
10.1258/rsmmsl.43.3.267
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Rie Esaki
中科院分区：
文献类型：
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作者：
N. Nishida;N. Ikeda;K. Kudo;Rie Esaki
一名51岁的男子在被捕时突然昏倒。他是一个滥用甲基苯丙胺（MP）的人，有前科。尸检时的血MP浓度低于致死水平。心脏显示双侧心室肥大和内膜增厚。在显微镜检查中，未观察到肥厚型心肌病的典型结果，但在所有心室和心房中观察到内膜增厚伴弹性纤维增加。在传导系统中，房室结动脉管腔狭窄，被周围组织纵向压迫。严重的间质纤维化和小的上级室间隔瘢痕形成也被看到。此外，在肺实质中观察到弥漫性高血压肺动脉病。我们推测，由于心内压的慢性增加，房室结动脉已被环周结构慢性压迫。我们认为，在我们的病例中，在心脏传导系统和肺中观察到的病理性病变可能是MP滥用的并发症，并且患有这种病变的MP滥用者在经历情绪压力时很容易突然死亡。
A 51-year-old man suddenly collapsed while being arrested. He was an abuser of methamphetamine (MP) with a history of previous convictions. The blood MP concentration at autopsy was below the lethal level. The heart revealed hypertrophy and endocardial thickening of the bilateral ventricles. On microscopic examination, the typical findings of hypertrophic cardiomyopathy were not seen, however endocardial thickening with increasing elastic fibres was seen in all the ventricles and in the atria. In the conduction system, the AV node artery with luminal narrowing was longitudinally compressed by circumferential tissue. Severe interstitial fibrosis and small scar formation of the superior ventricular septum were also seen. In addition, diffuse hypertensive pulmonary arteriopathy was seen in the lung parenchyma. We surmise that the AV node artery had been chronically compressed by the circumferential architecture, due to a chronic increase in intracardiac pressure. We believe that the pathological lesions noted in both the cardiac conduction system and the lung in our case may be a complication of MP abuse, and that an MP abuser with such lesions could easily die suddenly upon experiencing emotional stress.