QI have two women who want to kill one of their husbands. They decide to grind up some propanalol, which one of them uses for stage fright, and mix it in Indian food to cover up the taste. How would the victim actually die? Does his heart stop? Is there any vomiting or anything like that? What would an autopsy and toxicological testing show? Could it look like a heart attack or some other natural death and avoid toxicological testing?
Laura Caldwell
Author of Long Way Home and a Claim of Innocence Chicago, Illinois
APropranolol is a beta-blocker, which means that it blocks the effects of adrenaline on the cardiovascular system. It lowers blood pressure (BP) and heart rate, which are desired effects when treating hypertension and certain cardiac arrhythmias. It is also used for stage fright and certain other anxiety syndromes. A large dose can cause the BP and heart rate to drop dramatically, and the victim can slip into shock and die. The first symptoms would be weakness, fatigue, shortness of breath, and dizziness followed by loss of consciousness and death.
The symptoms would start anywhere from twenty minutes to an hour after ingestion, depending on factors such as the exact dose, the size of the victim, how much food was consumed along with it, and the victim’s general health. These symptoms would then progress to coma and death over the next thirty minutes to a couple of hours. This is highly variable, so have the symptoms begin and progress as you need as long as you stay within these broad parameters.
The death might indeed be declared a heart attack or a cardiac arrhythmia. An autopsy would show no heart attack, but a cardiac arrhythmia leaves behind no autopsy evidence. The ME would make a best guess. Propranolol would not appear on most routine toxicological screens, so the ME would have to look for it specifically. He would do that only if some evidence came forward that drugs might have been involved in the man’s death. Otherwise it is too expensive to simply test for it and see what turns up.