Análisis estructural del tejido especializado de conducción en muerte súbita relacionada con el consumo crónico de cocaína

Abstract

In cases of death from drug addiction, especially cocaine, forensic investigation should not be limited to external and internal examination of the corpse and toxicological analysis, but must be investigate lesions in the conduction system which sometimes explains sudden death, especially in young subjects. Examination of the conduction tissue is also useful because the cardiac toxicity of drugs in general, and cocaine in particular, can lead to myocardial structural alterations as foci of fibrosis and acceleration of coronary atherosclerosis. Such injuries may be the morphological substrate of the arrhythmia and lead to sudden death. For this study we have used 27 human specialized tissues obtained from anatomical parts that comprise the region of the sinus node, atrioventricular node (AV), bundle of His and its branches. The age of the corpses is between 20 and 35 years old, and all have a known history of chronic cocaine and died suddenly. As control samples were used 23 blocks of tissue from the sinus node, AV bundle and hearts of corpses belonging to the Department of Human Anatomy, Faculty of Medicine of Badajoz who have not died from cardiac causes or coronary abnormalities, or been drug of abuse consumers. When we compare the samples our results show severe disturbances in the conduction tissue and its vascularization.