Association between the intake of cocaine and a strong physical and emotional stress: a case report of a sudden death

Cocaine is a powerful sympathomimetic agent, that determines its effects either by inhibiting synaptic re-uptake of noradrenaline or through the direct stimulation of the release of catecholamines from the adrenal gland. Cocaine abuse is associated with various cardiovascular events including ventricular arrhytmias, systemic hypertension, myocardial infarction and left ventricular hypertrophy. These effects are independent of the dose and route of administration of the substance and can be noticeably enhanced by the synergistic action of factors such as stress, smoking and alcoholism. The case that we report has involved a 48 year old man, who died of acute myocardial infarction, which arose as the result of an intake of a large amount of cocaine and a strong physical and emotional stress.