Coronary artery intimal hyperplasia, occlusive platelet thrombus, and fatal myocardial infarction in an intravenous cocaine user

A 38-year-old man died of an acute inferoposterior myocardial infarction, shortly after intravenous injection of cocaine. At necropsy, diffuse intimal hyperplasia and an occlusive platelet thrombus involved the left main, left anterior descending, and the left circumflex coronary arteries. The possible relation of these morphologic findings to the effects of cocaine on platelet and coronary vascular function are discussed and the relevant literature is reviewed.