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Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
CASE REPORT
Marijuana-associated ST-elevation myocardial infarction: is this a benign drug
  1. Sundeep Kumar1,2,
  2. Ruthvik Srinivasamurthy1,
  3. Olga Karasik1 and
  4. Aamir Javaid1
  1. 1 Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, Florida, USA
  2. 2 Department of Internal Medicine, Orlando VA Medical Center, Orlando, Florida, USA
  1. Correspondence to Dr Sundeep Kumar, drkumar.sundeep{at}gmail.com

Abstract

Marijuana is the most commonly used psychoactive drug in the USA. A 35-year-old man with a medical history of marijuana abuse is admitted to the hospital due to crushing substernal chest pain. ECG shows evolving ST-segment elevation with a rise in cardiac enzymes, consistent with ST-elevation myocardial infarction. A urine toxicology screen is positive for cannabis and negative for cocaine and other stimulant drugs. An emergent cardiac catheterisation reveals no evidence of coronary artery disease or thrombosis. A diagnosis of coronary vasospasm is strongly considered, and the patient is started on calcium channel blocker, with a resolution of symptoms and ECG changes. Marijuana-induced coronary spasm causing myocardial infarction has rarely been reported. Marijuana is becoming a social norm in adolescents and there remains a misconception that it is harmless and even beneficial. Increasing drug abuse remains a public health concern, necessitating population education by physicians for safer healthcare practices.

  • cardiovascular medicine
  • drugs and medicines
  • public health
  • interventional cardiology

https://doi.org/10.1136/bcr-2018-226894

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    Footnotes

    • Patient consent for publication Obtained.

    • Contributors SK contributed to conception and drafting the manuscript and literature search. RS contributed to conception and design of manuscript and acquisition of data. OK contributed to design of the manuscript and critical revisions. AJ contributed to critical revision of the manuscript and conception of the manuscript. The final draft was reviewed and approved for submission by all the authors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.