A 27-year-old man presented to the emergency department of a tertiary care centre with complaints of acute onset breathing difficulty and retrosternal chest discomfort of 6 hours’ duration. On primary survey, he was dyspnoeic with a room air saturation of 85% and a blood pressure of 80/50 mm Hg. A bedside ultrasound revealed an ejection fraction of around 40%, with hypokinesia of interventricular septum, left ventricular apex and anterior wall with bilateral multiple B lines in all lung zones. A 12 lead ECG showed ST segment elevation in leads V2-V6. He sustained a cardiac arrest. Return of spontaneous circulation was achieved following high-quality cardiopulmonary resuscitation. After successful resuscitation, the patient underwent primary percutaneous coronary intervention and recovered fully from the event. On further evaluation, an acute binge of marijuana smoking prior to the onset of symptoms was identified as the cause of the acute coronary syndrome.
- interventional cardiology
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Contributors AV: Conception of the work, management of the case, drafting the article, guarantor of the work and final approval of the version to be published. VN: Conception of the work, drafting the article, critical revision, guarantor of the work and final approval of the version to be published. AK: Critical revision, interpretation of the case details and final approval of the version to be published. HB: Collection of the case details, management of the case, formatting of the report and final approval of the version to be published.
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.
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