MARIJUANA-INDUCED ACUTE CORONARY SYNDROME IN A YOUNG PATIENT

Abstract

Introduction: Acute coronary syndrome (ACS) is generally a natural consequence of the progression of coronary atherosclerosis. But in minority of cases, it might be developed due to non-atherosclerotic reasons including recreational marijuana use. Possible pathophysiological mechanisms include inflammation, procoagulant state and vasoconstriction (vasospasm) of the coronary arteries. Marijuana adverse effects on cardiovascular system are various and well documented. Case report: We present a 29-years old male who was referred to our Clinic due to chest pain and morphologic ECG changes. The patient has been previously hospitalized in local hospital due to hematochezia. Because of the chest pain, ECG was performed, and blood sample was taken there to determine the troponin level (hs-Tn I). ST-segment elevation and high level of hsTn I were indication for urgent transfer of the patient to our clinic. After admission, the patient underwent coronary angiography and PCI. Thoroughly taken history revealed that the patient was occasionally smoking marijuana in recreational purposes. He was a cigarette smoker, but he had no additional known risk factors for CAD. Conclusion: Recreational marijuana use may be a trigger factor for an acute coronary syndrome. We should always think and suspect marijuana and other recreational drugs as a potential risk factor for adverse cardiovascular events in young patients.