Author/Authors :
Ul Haq, E. University of South Alabama, Mobile, AL, USA , Shafiq, A. Saint Luke’s Mid America Heart Institute, Kansas City, USA , Khan, A.A. John Hunter Hospital, Newcastle, NSW, Australia , Awan, A.A. Hattiesburg Clinic, Hattiesburg, MS, USA , Ezad, S. John Hunter Hospital, Newcastle, NSW, Australia , Minteer, W. J. Cardiology Department - Appalachian Regional Healthcare, Middlesboro, USA , Omar, B. University of South Alabama, Mobile, AL, USA
Abstract :
Marijuana is the most widely abused “recreational” substance in the United States, with highest prevalence in young adults. It is
reported to cause ischemic strokes, hepatitis, anxiety, and psychosis. Although it is associated with dose dependent tachycardia
and can lead to coronary vasospasm, it has not been directly related to acute myocardial infarction (AMI). Marijuana induced
coronary vasospasm can result in endothelial denudation at the site of a vulnerable atherosclerotic plaque in response to
hemodynamic stressors, potentially causing an AMI. Spice refers to herbal mixture with composition and effects similar to that
of marijuana and therefore is referred to as “synthetic marijuana.” Herein, we report 3 cases of spice induced ST-segment elevation
myocardial infarction. All patients were relatively young and had few or absolutely no risk factors for cardiovascular disease. All
patients underwent emergent coronary angiography, with two needing stent placement and the third requiring only aspiration
thrombectomy. Our case series emphasizes the importance of suspecting and investigating synthetic marijuana use in low risk
young adults presenting with AMI.
