Prolonged cardiac arrest complicating a massive ST-segment elevation myocardial infarction associated with marijuana consumption

Abstract

Recreational substance use and misuse constitute a major public health issue. The annual rate of recreational drug overdose-related deaths is increasing exponentially, making unintentional overdose as the leading cause of injury-related deaths in the United States. Marijuana is the most widely used recreational illicit drug, with approximately 200 million users worldwide. Although it is generally regarded as having low acute toxicity, heavy marijuana usage has been associated with life-threatening consequences. Marijuana is increasingly becoming legal in the United States for both medical and recreational use. Although the most commonly seen adverse effects resulting from its consumption are typically associated with neurobehavioral and gastrointestinal symptoms, cases of severe toxicity involving the cardiovascular system have been reported. In this report, the authors describe a case of cannabis-associated ST-segment elevation myocardial infarction leading to a prolonged cardiac arrest.

Cardiovascular Complications of Marijuana and Related Substances: A Review

“…In fact, electrophysiology study after cannabis use has demonstrated increased burden of inducible premature ventricular contractions [ 111 ]. Myocardial ischemia caused by microvascular spasm, AMI, or pre-existing CAD may accompany serious ventricular arrhythmias and may result in dizziness, syncope, cardiac arrest or sudden cardiac death [ 29 , 103 – 110 , 112 ].…”

Association of recreational drug consumption, cardiac toxicity and heart transplantation

“…Although secondary cardiac toxicity has been established, clinical cases of myocardial effect are not well described. [1][2][3] The present study suggests an association between active use of a combination of recreational drugs in young adults, the occurrence of acute cardiac failure necessitating mechanical support of diseased hearts and transplantation.…”

Cardiovascular events post cannabis abuse during the COVID-19 pandemic

“…(12,21), indicating the coronary vasospasm as the most possible cause of these CVD events (24). Retrospective systematic review of published articles showed ST segment elevation in 60% of EKGs, 36,8% of patients had normal coronary arteries, 35% had LAD coronary artery occlusion and 34% of cases had concomitant cardiomyopathy compared to non-users (30)(31)(32).…”