ToxicologyCoronary no-flow and ventricular tachycardia associated with habitual marijuana use☆
Introduction
Marijuana smoking is a widespread habit. Contrary to other addictive drugs, its use is perceived to be safe and might even have some therapeutic potential. Marijuana use has been linked to myocardial infarction and sudden death, but no definite mechanism has been established. Most patients appear to have normal coronary arteries at angiography or at autopsy. We report the case of a 34-year-old man with habitual marijuana use who had ventricular tachycardia. Angiography revealed a significant decrease in coronary flow, and clinical ventricular tachycardia was inducible at electrophysiologic testing. After verapamil therapy and cessation of marijuana use, his coronary flow normalized, and ventricular tachycardia was no longer inducible. Abnormalities of coronary microcirculation are a plausible theory for marijuana-induced cardiac events.
Section snippets
Case report
We report the case of a 34-year-old man who reported occasional “heart fluttering” with dizziness for the past several months. On the day of admission, he was working in his garden when he experienced palpitations, shortness of breath, chest pain, and near syncope. The patient smoked less than half a pack of cigarettes per day. He smoked marijuana twice a day, using a glass pipe. He usually consumed one-quarter to one-half ounces a week, and the last time he smoked marijuana was 3 hours before
Discussion
Cannabis is available in 3 main forms: dried herb from top leaves and buds, a resin (hash) extracted from the buds and flower heads, and a hash oil prepared from the resin.1 All forms can be ingested through different routes, yet the most common route is smoking either the pure substance or the pure substance mixed with tobacco leaves.
Contrary to most addictive drugs, marijuana is perceived by some to be safe, without any significant cardiovascular effects. Occasional cases of myocardial
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The authors report this study did not receive any outside funding or support.