Cocaine in Hospital Admissions for Diseases of the Circulatory System and as the Underlying Cause of Death: Analysis and Discussion

  • Ana SanturtúnEmail author
  • Ana García Blanco
  • Pablo Fdez-Arroyabe
  • Maite Santurtún
  • María Teresa Zarrabeitia


Cocaine is a cardiotoxic drug which has been associated with morbi-mortality due to cardiovascular diseases (CVD). This study aims to: (1) analyze the hospitalizations due to cardiovascular processes and the presence of cocaine among the toxic habits of patients; and (2) discuss the forensic difficulties in sudden cardiac death (SCD) in the presence of cocaine. Hospital discharges due to CVD reporting cocaine consumption as a secondary diagnosis between 2003 and 2013 in Spain were analyzed. Subsequently, a review of judicial autopsies (SCD in cocaine users) was carried out to illustrate the forensic difficulties in the determination of the manner and underlying cause of death when cocaine use is involved. The average CVD morbidity rate was 1104.4 per 100,000 population. The most common main diagnoses of which cocaine use was recorded as a secondary diagnosis were rheumatic fever, ischemic heart disease and cerebrovascular disease in male patients between 15 and 44 years. The cardiovascular findings in the autopsies of cocaine users vary, and determining the mechanism that triggered the death in forensic practice is a challenge. The presence of cocaine among the toxic habits of young patients admitted for CVD in Spain is increasing. In our opinion, criteria must be unified to establish the manner and underlying cause of death in SCD and toxicological analysis can be a key part in the process.


Cocaine Sudden death Cardiovascular disease Ischemic heart disease Medico-legal autopsy 



Sudden cardiac death


Cardiovascular diseases


International Classification of Diseases


Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

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Supplementary material 1 (DOCX 19 kb)


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Unit of Legal Medicine, Department of Physiology and PharmacologyUniversity of CantabriaSantanderSpain
  2. 2.Pathology ServiceInstitute of Legal Medicine of CantabriaSantanderSpain
  3. 3.Department of NursingUniversity of CantabriaSantanderSpain
  4. 4.Centro Hospitalario Padre MenniSantanderSpain
  5. 5.Department of Geography, Urban Planning and Territorial PlanningUniversity of CantabriaSantanderSpain

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