Immunohistochemical detection of early myocardial damage in two sudden deaths due to intentional butane inhalation. Two case reports with review of literature

Novosel, Irena; Kovačić, Zdravko; Gusić, Stjepan; Batelja, Lovorka; Nestić, Marina; Seiwerth, Sven; Škavić, Josip

doi:10.1016/j.jflm.2010.12.003

Cited by 22 publications

(14 citation statements)

References 20 publications

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“…On the other hand, the cause of death was decided to be arrhythmia in cases where bagging was denied or the deceased was able to move for a short time after bagging. It seems there is congestion of internal organs and lung edema to some degree [27][28][29]; however, there are no pathological findings specific to butane inhalation. When relatively high butane concentrations were observed and no other possible causes of death were present, the cause of death was determined to be butane poisoning [25,26].…”

Section: Discussionmentioning

confidence: 96%

Fatal butane inhalation from gas cartridges: a case report and literature review

Kimura-Kataoka¹,

Fujihara²,

Yasuda³

et al. 2015

RJLM

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Volatile substances are commonly misused with easy-to-obtain commercial products, such as glue, shoe polish, nail polish remover, butane lighter fluid, gasoline and computer duster spray. This report describes a case of sudden death of a 29-year-old woman after presumably inhaling gas cartridge butane from a plastic bag. Autopsy, pathological and toxicological analyses were performed in order to determine the cause of death. Pulmonary edema was observed pathologically, and the toxicological study revealed 2.1μL/mL of butane from the blood. The causes of death from inhalation of volatile substances have been explained by four mechanisms; cardiac arrhythmia, anoxia, respiratory depression, and vagal inhibition. In this case, the cause of death was determined to be asphyxia from anoxia. Additionally, we have gathered fatal butane inhalation cases with quantitative analyses of butane concentrations, and reviewed other reports describing volatile substance abuse worldwide.

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Section: Discussionmentioning

confidence: 96%

Fatal butane inhalation from gas cartridges: a case report and literature review

Kimura-Kataoka¹,

Fujihara²,

Yasuda³

et al. 2015

RJLM

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“…3 The butane-propane inhalation, according to some authors, causes a burst of catecholamines that can trigger ventricular fibrillation. 2 Furthermore, some authors 4,5 suppose that butane may sensitize the myocardium to adrenaline, resulting in a fatal arrhythmia.…”

Section: Discussionmentioning

confidence: 99%

A Fatal Case of Acute Butane-Propane Poisoning in a Prisoner Under Psychiatric Treatment

Gioia¹,

Lancia²,

Bacci³

et al. 2015

American Journal of Forensic Medicine &Amp; Pathology

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Sudden death due to inhalation of aliphatic hydrocarbons such as butane and propane is well described in the literature. The main mechanism involved is the induction of a fatal cardiac arrhythmia. This phenomenon is frequently associated with prisoners who accidentally die while sniffing these volatile substances with an abuse purpose. Furthermore, such prisoners are often under psychiatric treatment; specific drugs belonging to this pharmacological class lead to a drug-related QT interval prolongation, setting the stage for torsade de pointes. In this article, we present the case of a prisoner died after sniffing a butane-propane gas mixture from a prefilled camping stove gas canister. The man was under psychiatric drugs due to mental disorders. He was constantly subjected to electrocardiogram to monitor the QTc (corrected QT interval), which was 460 milliseconds long. Toxicological analysis on cadaveric samples was performed by means of gas chromatography (head space) and revealed the presence of butane and propane at low levels. The aim of this article was to discuss a possible arrhythmogenic interaction of QT interval prolongation induced by psychiatric drugs and butane-propane inhalations, increasing the cardiovascular risk profile. In other words, evidence may suggest that prisoners, under these circumstances, are more likely to experience cardiovascular adverse effects. We believe that this study underlines the need to take this hypothesis into account to reduce death risk in prison and any medical-related responsibilities. Further studies are needed to validate the hypothesis.

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“…Death can occur from accidental trauma (falling, etc. ), asphyxiation by the bag covering the face, aspiration of the compound or vomit, anoxia, cardiac dysfunction, CNS depression, severe allergic reaction, or extreme injury to the lungs (Adgey et al, 1995;Bowen, 2011;Bowen et al, 1999a,b;Garriott and Petty, 1980;Garriott, 1992;Hahn et al, 2006;Kringsholm, 1980;Maxwell, 2001;Novosel et al, 2011;Potocka-Banas et al, 2011). Death can also occur because of fire as some canisters are heated to enhance the amount of solvent available which may result in combustion.…”

Section: Acutementioning

confidence: 99%

“…Long-term misuse of inhalants has also been reported to result in cardiovascular damage including myocardial edema and ischemia, fibrous, and congestive heart failure Flanagan et al, 1990;Novosel et al, 2011). Inhalant abuse may also produce cardiovascular sensitivity to endogenous catecholamines, so much so that any increase in excitement or physical activity may cause death (Adgey et al, 1995).…”

Section: Chronicmentioning

confidence: 99%

Inhalants

Bowen

Cruz

2014

The Effects of Drug Abuse on the Human Nervous System

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Immunohistochemical detection of early myocardial damage in two sudden deaths due to intentional butane inhalation. Two case reports with review of literature

Cited by 22 publications

References 20 publications

Fatal butane inhalation from gas cartridges: a case report and literature review

Fatal butane inhalation from gas cartridges: a case report and literature review

A Fatal Case of Acute Butane-Propane Poisoning in a Prisoner Under Psychiatric Treatment

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