Cardiac vein thrombosis and haemorrhagic myocardial necrosis; report of a case with review of the literature

A 29-year-old woman, addicted to heroin since the age of 15 years, presente d with a 4-day history of acute inspiratory chest pain, dyspnoea and vomiti ng associated with hypoventilation. She died 3 h after admission to the int ensive care unit in spite of active resuscitative measures. The main autops y findings were limited to the heart, which showed widespread cardiac vein thrombosis, and both ventricles and the atria were associated with multiple areas of haemorrhagic myocardial necrosis. We review the literature of thi s uncommon pathological entity and discuss its possible pathogenesis.