Lethal inhalation of Popper

Abstract

We present a case about an unexpected death occurred during inhalation of Popper, a recreational drug constituted by alkyl nitrates, which is generally considered safe for life, despite its activity on cardiovascular system. Fatal inhalation of nitrates are extremely rare in world literature; the dangerousness from nitrate are primarily related to the synthesis of methaemoglobin, the oxidative form of haemoglobin, which cannot carry oxygen causing hypoxia. In some instances death from nitrates can derivate from lethal arrhythmias induced by a sensibilisation of myocardium to cathecolamine. In our case toxicological analysis were hampered by advanced putrefaction, but nevertheless it was possible to asses in biological samples the presence of Butyraldehyde dibutylacetal, a molecule originated during the chemical synthesis of nitrates but more stable, that confirmed the assumption of Popper just before the death.