A 29-year-old man died from aortic dissection and cardiac tamponade after taking ecstasy (MDMA) at a rave. He had no history of hypertension or other known risk factors for aortic dissection, though a minor degree of cystic medial necrosis was found in the aorta. Autopsy toxicology showed low residual MDMA levels in the blood about 48 hours after ingestion. The report suggests a probable link between MDMA use and aortic dissection in a previously healthy young adult, discusses possible mechanisms, and notes challenges in diagnosing this complication.
From 2000 to 2023 in Australia, 43 deaths involving LSD (33 cases) or psilocybin (10 cases) were identified. Most deaths were from traumatic accidents (36.4% for LSD, 40.0% for psilocybin) or self-harm by physical means (12 cases, all involving LSD). Multiple drug toxicity accounted for about a fifth of deaths. Only one death was attributed solely to LSD toxicity, and two followed a cardiovascular event after LSD use. In four psilocybin cases the cause was undetermined. Severe agitation was the most common clinical presentation. Median blood concentrations were 0.8 μg/l for LSD and 20 μg/l for psilocin. Pre-existing organ pathology was uncommon.