Korean Circ J.  2012 Sep;42(9):641-645. 10.4070/kcj.2012.42.9.641.

Acute Myocardial Infarction in a Young Man; Fatal Blow of the Marijuana: A Case Report

• Yurtdas M
• Aydin MK

• KMID: 2297898
• DOI: http://doi.org/10.4070/kcj.2012.42.9.641

Abstract

Marijuana is known to have been used for medicinal and recreational purposes for thousands of years. Although marijuana has some diverse effects on cardiovascular system, there is insufficient knowledge concerning acute myocardial infarction (AMI) associated with marijuana and its underlying mechanism. We report the case of a 26 year-old young man suffering from ST-elevated AMI caused by marijuana abuse, which was successfully treating with percutaneous coronary intervention. It should be kept in mind that marijuana could be one of the most probable causes of AMI observed in apparently healthy young persons who use this drug.

Keyword

Cannabis; Myocardial infarction

MeSH Terms

Cannabis
Cardiovascular System
Humans
Marijuana Abuse
Myocardial Infarction
Percutaneous Coronary Intervention
Stress, Psychological

Figure

• 

  Fig. 1 Electrocardiogram shows sinus rhythm and ST-segment elevation in the emergency room (A), and nearly complete resolution of ST-segment elevation with Q-wave in the inferior leads after percutaneous coronary intervention (B).

• 

  Fig. 2 Left anterior oblique view of a large thrombotic occlusion of the proximal part of the right coronary artery.

• 

  Fig. 3 Right anterior oblique cranial view of a thrombolysis in myocardial infarction-III flow after successfully treated with percutaneous coronary intervention of the thrombotic right coronary artery.

Reference

1. Aktaş EÖ, Koçak A, Şenol E, et al. Evaluation of narcotic and stimulant drugs and abusers captured in Aegean region. Turkiye Klinikleri J Foren Med. 2006. 3:13–24.

2. Mach F, Montecucco F, Steffens S. Cannabinoid receptors in acute and chronic complications of atherosclerosis. Br J Pharmacol. 2008. 153:290–298.

3. MacInnes DC, Miller KM. Fatal coronary artery thrombosis associated with cannabis smoking. J R Coll Gen Pract. 1984. 34:575–576.

4. Rezkalla SH, Sharma P, Kloner RA. Coronary no-flow and ventricular tachycardia associated with habitual marijuana use. Ann Emerg Med. 2003. 42:365–369.

5. Caldicott DG, Holmes J, Roberts-Thomson KC, Mahar L. Keep off the grass: marijuana use and acute cardiovascular events. Eur J Emerg Med. 2005. 12:236–244.

6. Tatli E, Yilmaztepe M, Altun G, Altun A. Cannabis-induced coronary artery thrombosis and acute anterior myocardial infarction in a young man. Int J Cardiol. 2007. 120:420–422.

7. Dwivedi S, Kumar V, Aggarwal A. Cannabis smoking and acute coronary syndrome: two illustrative cases. Int J Cardiol. 2008. 128:e54–e57.

8. Cappelli F, Lazzeri C, Gensini GF, Valente S. Cannabis: a trigger for acute myocardial infarction? a case report. J Cardiovasc Med (Hagerstown). 2008. 9:725–728.

9. Basnet S, Mander G, Nicolas R. Coronary vasospasm in an adolescent resulting from marijuana use. Pediatr Cardiol. 2009. 30:543–545.

10. Kocabay G, Yildiz M, Duran NE, Ozkan M. Acute inferior myocardial infarction due to cannabis smoking in a young man. J Cardiovasc Med (Hagerstown). 2009. 10:669–670.

11. Bailly C, Merceron O, Hammoudi N, Dorent R, Michel PL. Cannabis induced acute coronary syndrome in a young female. Int J Cardiol. 2010. 143:e4–e6.

12. Karabulut A, Cakmak M. ST segment elevation myocardial infarction due to slow coronary flow occurring after cannabis consumption. Kardiol Pol. 2010. 68:1266–1268.

13. Canga Y, Osmonov D, Karataş MB, Durmuş G, Ilhan E, Kırbaş V. Cannabis: a rare trigger of premature myocardial infarction. Anadolu Kardiyol Derg. 2011. 11:272–274.

14. Schmid J, Auer J. Spontaneous coronary artery dissection in a young man - case report. J Cardiothorac Surg. 2011. 6:22.

15. Aronow WS, Cassidy J. Effect of marihuana and placebo-marihuana smoking on angina pectoris. N Engl J Med. 1974. 291:65–67.

16. Mittleman MA, Lewis RA, Maclure M, Sherwood JB, Muller JE. Triggering myocardial infarction by marijuana. Circulation. 2001. 103:2805–2809.

17. Mukamal KJ, Maclure M, Muller JE, Mittleman MA. An exploratory prospective study of marijuana use and mortality following acute myocardial infarction. Am Heart J. 2008. 155:465–470.

18. Kosior DA, Filipiak KJ, Stolarz P, Opolski G. Paroxysmal atrial fibrillation following marijuana intoxication: a two-case report of possible association. Int J Cardiol. 2001. 78:183–184.

19. Camaro C, Aengevaeren WR. Acute myocardial infarction due to coronary artery embolism in a patient with atrial fibrillation. Neth Heart J. 2009. 17:297–299.