Spontaneous Coronary Artery Dissection in the Setting of Marijuana: A Case Report

Abstract

This case report presents a detailed examination of spontaneous coronary artery dissection (SCAD) in a 61-year-old Middle Eastern male with a history of marijuana use and essential hypertension. The patient's emergency presentation with loss of consciousness and subsequent diagnostics - including elevated troponins and distinctive electrocardiogram changes - led to the identification of extensive SCAD affecting multiple coronary arteries. The association between marijuana use and cardiovascular pathology is focal in this study, particularly considering the patient's positive test for tetrahydrocannabinol (THC) and significant smoking history. This case highlights the critical need for heightened awareness among clinicians regarding the implications of recreational marijuana use, particularly in individuals with predisposing cardiovascular risk factors. Furthermore, it illustrates the complexity of diagnosing and managing SCAD, a condition that may vary widely in its presentation and severity, necessitating a tailored approach to treatment that considers both the acute manifestations and underlying contributory factors such as substance use.

Keywords: cardiovascular risk; coronary angiography; marijuana; smoking cessation; spontaneous coronary artery dissection.

Figure 1. The angiographic findings showing diffuse coronary artery dissection - part 1

Figure 2. The angiographic findings showing diffuse coronary artery dissection - part 2

Figure 3. The angiographic findings showing diffuse coronary artery dissection - part 3