Spontaneous renal artery dissection in a cannabis user

Lou, Junyang; Randhawa, Mandeep Singh; Hornacek, Deborah; Bajzer, Christopher

doi:10.1177/1358863x15575770

Cited by 9 publications

(5 citation statements)

References 2 publications

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“…Subacute and progressive ischemia of upper and lower extremities affected by arteritis may then lead to serious complications including tissue necrosis and gangrene with worsening during periods of heavy cannabis use [ 130 ]. Other vascular complications of cannabis use have included migratory thrombophlebitis [ 131 ] and renal artery dissection [ 132 ]. A rare form of vasculopathy involving occlusion of the central retinal vein has also been reported [ 133 ].…”

Section: Cardiovascular Complications Of Cannabinoid Usementioning

confidence: 99%

Cardiovascular Complications of Marijuana and Related Substances: A Review

et al. 2017

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The recreational use of cannabis has sharply increased in recent years in parallel with its legalization and decriminalization in several countries. Commonly, the traditional cannabis has been replaced by potent synthetic cannabinoids and cannabimimetics in various forms. Despite overwhelming public perception of the safety of these substances, an increasing number of serious cardiovascular adverse events have been reported in temporal relation to recreational cannabis use. These have included sudden cardiac death, vascular (coronary, cerebral and peripheral) events, arrhythmias and stress cardiomyopathy among others. Many of the victims of these events are relatively young men with few if any cardiovascular risk factors. However, there are reasons to believe that older individuals and those with risk factors for or established cardiovascular disease are at even higher danger of such events following exposure to cannabis. The pathophysiological basis of these events is not fully understood and likely encompasses a complex interaction between the active ingredients (particularly the major cannabinoid, Δ9-tetrahydrocannabinol), and the endo-cannabinoid system, autonomic nervous system, as well as other receptor and non-receptor mediated pathways. Other complicating factors include opposing physiologic effects of other cannabinoids (predominantly cannabidiol), presence of regulatory proteins that act as metabolizing enzymes, binding molecules, or ligands, as well as functional polymorphisms of target receptors. Tolerance to the effects of cannabis may also develop on repeated exposures at least in part due to receptor downregulation or desensitization. Moreover, effects of cannabis may be enhanced or altered by concomitant use of other illicit drugs or medications used for treatment of established cardiovascular diseases. Regardless of these considerations, it is expected that the current cannabis epidemic would add significantly to the universal burden of cardiovascular diseases.Electronic supplementary materialThe online version of this article (10.1007/s40119-017-0102-x) contains supplementary material, which is available to authorized users.

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Section: Cardiovascular Complications Of Cannabinoid Usementioning

confidence: 99%

Cardiovascular Complications of Marijuana and Related Substances: A Review

et al. 2017

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“…In many instances, however, the worsening of the vascular disease was found to parallel the use of cannabis with halting of disease progression with abstinence from cannabis consumption (54). Lou et al (55) reported a rare case of spontaneous dissection of the renal artery in a cannabis user. They proposed chronic vasoconstriction, as the possible underlying mechanism by causing partial or complete vacuolization and lysis of the arterial media with deposition of fibrin at the interface between the adventitia and the media, eventually resulting in arterial rupture.…”

Section: Peripheral Vascular Effects Of Cannabismentioning

confidence: 99%

Role of cannabis in cardiovascular disorders

2017

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The growing popularity of medical and recreational consumption of cannabis, especially among the youth, raises immediate concerns regarding its safety and long-terms effects. The cardiovascular effects of cannabis are not well known. Cannabis consumption has been shown to cause arrhythmia including ventricular tachycardia, and potentially sudden death, and to increase the risk of myocardial infarction (MI). These effects appear to be compounded by cigarette smoking and precipitated by excessive physical activity, especially during the first few hours of consumption. Cannabinoids, or the active compounds of cannabis, have been shown to have heterogeneous effects on central and peripheral circulation. Acute cannabis consumption has been shown to cause an increase in blood pressure, specifically systolic blood pressure (SBP), and orthostatic hypotension. Cannabis use has been reported to increase risk of ischemic stroke, particularly in the healthy young patients. The endocannabinoid system (ECS) is currently considered as a promising therapeutic target in the management of several disease conditions. Synthetic cannabinoids (SCs) are being increasingly investigated for their therapeutic effects; however, the value of their benefits over possible complications remains controversial. Despite the considerable research in this field, the benefits of cannabis and its synthetic derivatives remains questionable even in the face of an increasingly tolerating attitude towards recreational consumption and promotion of the therapeutic complications. More efforts are needed to increase awareness among the public, especially youth, about the cardiovascular risks associated with cannabis use and to disseminate the accumulated knowledge regarding its ill effects.

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“…Adverse development of the media and alterations of the vasa vasorum, severe atherosclerosis, and blood flow shear stress may be pathogeny. Malignant hypertension, fibromuscular dysplasia (15), strenuous exercise (including sexual) (17), taking medication (18,19), Marfan syndrome (20), and Ehlers-Danlos syndromes ( 4) are all possible risk factors. In our two case studies, we found that both of the patients had a long history of smoking, which was similar to the reports by other researchers (6,11,21).…”

Section: Discussionmentioning

confidence: 99%