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Case Reports
. 2023 Apr 23;15(4):e38026.
doi: 10.7759/cureus.38026. eCollection 2023 Apr.

Marijuana as a Cause of Diffuse Coronary Vasospasm Leading to Cardiac Arrest

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Case Reports

Marijuana as a Cause of Diffuse Coronary Vasospasm Leading to Cardiac Arrest

Muhammad Atif Khan et al. Cureus. .

Abstract

Marijuana is considered as the most popular illicit drug around the world. It has numerous cardiovascular effects with myocardial infarction (MI) being a lethal one. The negative physiological effects of marijuana are well-studied, including tachycardia, nausea, memory impairment, anxiety, panic, and arrhythmia. We present a case of cardiac arrest following marijuana use in a patient who had a normal electrocardiogram (EKG) on presentation but diffuse coronary vasospasm on left heart catheterization (LHC) with no obstructive lesion. The patient had a transient episode of ST elevation on EKG following the procedure which resolved with an increased dose of nitroglycerine drip. Synthetic cannabinoids are more potent and not detected on a regular urine drug screen (UDS). In patients with low risk for cardiovascular events, particularly young adults, presenting with symptoms of MI/cardiac arrest, marijuana-induced MI should be suspected due to the severe adverse effects of its synthetic component.

Keywords: cardiac arrest; coronary spasm; illicit drugs; marijuana use; st myocardial infarction.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Coronary vessels diffuse spasms before intracoronary nitroglycerin (arrows pointing to multiple vessels to show diffuse nature)
Figure 2
Figure 2. Coronary vessels dilatation after intracoronary nitroglycerin (arrows pointing to multiple vessels to show diffuse nature)
Figure 3
Figure 3. Transient changes on EKG following LHC
EKG: Electrocardiogram; LHC: Left heart catheterization

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