Fatal acute congestive heart failure in a patient with idiopathic hemochromatosis and cocaine use

Cardiovascular complications from cocaine use have been recognized in increasing frequency in recent years. We report the case of a young man with a history of intranasal cocaine use presenting with acute congestive heart failure who, on postmortem examination, was found to have idiopathic hemochromatosis. It is speculated that cocaine played a synergistic role in depressing myocardial function in a heart which had already been compromised by the diffuse iron deposition associated with hemochromatosis.