Drug that makes death seem to be a heart attack?

No, I’m not looking for help in getting away with murder. I’m plotting out a historical mystery, in which my victim must (must) die of a heart attack but where my sleuth suspects nefarious play. What causes (probably drugs) would he be suspecting? It’s not a major issue in the book, so I won’t need a lot of technical details, but I’ll need something tangible when my character kicks off, about fifty pages from now.

Since my book takes place in the fall of 1940, it would need to have been available then, whatever it is.

The victim is in his mid-40s, has some history of heart problems (one previous heart attack), is a heavy drinker.

I saw one of those crime-solving shows on A&E or someplace that mentioned such a drug. Only it was from a modern crime. IIRC the drug (some sort of veterinary drug?) was virtually undetectable until somebody linked the clues and came up with a test. I wish I could remember the name of it.

I seem to remember an Agatha Christie novel in which an overdose of the chemical found in foxgloves (digitalis? digitalin? Something like that) causes someone with a bad heart to suffer a stroke. Maybe I’m misremembering, though.

Presumably anything that would raise the blood pressure/thicken the blood would do harm if reguarly administered. Just giving them a dose of sodium every so often might bring on a heart attack.

I don’t know, how well would a coroner detect a fatal overdose of a CNS stimulant or an opiate in 1940s?

One technique I’ve seen in several espionage novels is to inject the victim with air from an empty syringe. Supposedly, this causes an embolism or something which is almost indistinguishable from a normal heart attack. The only visible sign of foul play is the needle mark, so unless the victim is already an intravenous drug user (medical or otherwise) you’ll want to hide that, for example by sticking the needle into a haemorrhoid (yuck!).

I also seem to remember a Tom Clancy novel in which a method like that was used, andthe only detectable symptom was a slight discoloration of the victim’s gums. The murderer knew that the coroners would look for that, so he used some kind of make-up to conceal the discoloration.
As you can probably tell, this is coming from the very depths of my failing memory – any Clancy fans know the details?

Needless to say, IANACoroner and all of the above comes from vague recollections of fictional works which are probable unreliable as medical textbooks to begin with, so you’ll want to do some research of your own before you base your plot on it.

There have been two episodes of Law & Order dealing with mysterious deaths that ended up being the result of mis-calculated insulin. I guess it was hard for the coroner to figure out because both injection marks on the body and insulin in the blood stream were expected. However, I am not sure that the end result of a huge insulin spike would look like a heart attack to a coroner.

I like the air idea too. Make your victim a diabetic and you can get away with good ideas for injected poison.

I had surgery a while back and as they were getting me ready to go I noticed bubbles in the tube running into my arm, a couple of them looked a trifle large for comfort to me. I asked the nurse about it and was told that the air bubble would have to a foot (or something like that, don’t really remember) long to be a problem.

Anywho, that my $.02 worth.

I was told potassium could do the trick.

Potassium causes cardiac arrest, which isn’t the same thing as a heart attack. I’m not a doctor, but I’d give even money that a coroner could tell the difference in 1940.

Priceguy: I now understand that it causes cardiac arrest rather than a heart attack, but could a doctor tell that potasium overdose was the cause of death?

Digitoxin, or possibly digoxin. Related plant poisons are strophanthin and ouabain, used as arrow poisons in Africa. (The arrow poison derived from strophanthus kombe was described by Livingstone.) I’ve no idea if these poisons mimic cardiac arrest - their Wikipedia descriptions suggest not - but they are certainly detectable after the event.

Re potassium chloride - a bit of googling turns up poisoning cases where it was detected, and cases where it was suspected but couldn’t be proven.

I’m a little bit sceptical of the “injected air bubble” method, since divers with the bends have their blood full of bubbles but rarely die. They also have some rather specific, non heart-related symptoms.


CMC fnord!

I don’t know if succinylcholine would have been available in 1940, but curare and maybe some of its derivative drugs would have been available, and the end result would be the same–death from respiratory arrest–and I do not think it is ever routinely tested for.

Maybe someone could correct me, but I also think ergot could cause a heart attack, especially in someone with preexisting coronary artery disease, due to its vasoconstrictive properties.

Cocaine would have certainly been available, as would amphetamines. Either of those could cause problems in someone with an already compromised heart.

I think the limiting factor here is what could be detected in blood in 1940. My feeling is that not much could be detected, but I have no idea what the state of forensic pathology was in 1940. Perhaps gabriela has an idea of the history?

The story was in The Tuesday Club Murders, published in 1932.

You need a really big air bubble to produce something akin to heart failure. Basically the bubble needs to be big enough to produce a cavitation effect within the heart. Air bubbles from the bends are miniscule and are rapidly passed through the heart.

I suppose in theory small air bubbles could produce heart failure if they dsomehow passed thorugh the lungs and managed to cause a clot in the cardiac vessels. That’s ridiculously implausible though.

That makes sense. What do you mean by a “cavitation effect”? Just peeked at Howstuffwork’s take on the heart, and I can see that a big bubble in an atrium might interfere with pumping (contraction just compresses the bubble), but I can’t see what would make a bubble stay there.