humulene and Vascular-Diseases

BACKGROUND Myocardial infarction (MI) is one of the most ominous medical emergencies because it carries significant morbidity and mortality. A myocardial bridge is an anomaly previously perceived as benign. However, with a better understanding, it is considered a risk factor for angina and MI in some cases. Certain precipitating factors potentiate the coronary artery within the myocardial bridge to having vasospasms. Cannabis is one of many potential precipitants for vasospasm in the setting of a myocardial bridge because it increases vascular tone and increases sympathetic hormone secretion in the form of noradrenaline. CASE REPORT We report a case of a 31-year-old man presenting with myocardial infarction, without any known traditional risk factors for cardiovascular disease. Upon investigation, we discovered that he had an underlying myocardial bridge, which in the setting of significant cannabis consumption, precipitated myocardial infarction with non-obstructive coronary arteries (MINOCA) disease on invasive angiography. CONCLUSIONS In a setting with an underlying risk factor or cardiac anomaly, cannabis can induce an MI and potentially other adverse cardiac complications. With the increasing use of cannabis in several regions of the world, more adverse events outside of the well-documented psychotropic effects of cannabis are anticipated. Therefore, clinicians need to bear in mind the multifaceted effects of adverse events from cannabis in the various organ systems and be prepared to ensure prompt treatment as needed. Given the nature of the pathophysiology of MINOCA in a patient with a myocardial bridge, it is paramount to be aware that the cause of infarction is a reversible one.

Topics: Adult; Cannabis; Coronary Angiography; Coronary Artery Disease; Coronary Vessels; Humans; Male; MINOCA; Myocardial Infarction; Risk Factors; Vascular Diseases

Topics: Cannabis; Emergency Service, Hospital; Humans; Incidence; Retrospective Studies; Self Report; Vascular Diseases

A 35-year-old woman was hospitalized for subacute ischemia of the left leg following an intermittent claudication for some weeks. She also presented paleness and coldness of both hands. The radial pulses could not be palpated. Smoking was the only cardiovascular risk factor. Duplex ultrasonography and angiography revealed a left popliteal thrombus combined with low diameter leg arteries and in the upper limbs stenosis of the left radial artery and thrombosis of the right radial artery. Search for a metabolic, embolic or thrombophilic etiology was negative. More minute history taking revealed use of cannabis and recent nasal administration of cocaine. Her condition improved with heparin therapy except for the upper limbs with ischemia of the hands and disabling Raynaud's phenomenon. This report highlights the combined arterial toxicity of drugs often used together by drug addicts. The association of cannabis use and tobacco smoking is not rare in patients with Buerger-like juvenile arteriopathy and cocaine may provoke peripheral vascular disease by embolism or in situ thrombosis. Interrogation of a patient presenting with Buerger-like peripheral arterial disease should insist on detecting use of drugs in association with tobacco smoking.

Topics: Adult; Cannabis; Cocaine; Constriction, Pathologic; Female; Hand; Heparin; Humans; Ischemia; Leg; Popliteal Artery; Radial Artery; Raynaud Disease; Smoking; Thrombosis; Vascular Diseases

Topics: Adolescent; Adult; Alanine Transaminase; Aspartate Aminotransferases; Bronchitis; Cannabis; Chemical and Drug Induced Liver Injury; Colic; Drug Hypersensitivity; Female; Gingivitis; Humans; Laryngitis; Liver Diseases; Male; Migraine Disorders; Otitis; Pharyngitis; Respiratory Tract Diseases; Sinusitis; Stomatitis; Substance-Related Disorders; Vascular Diseases