Akademik Veri Yönetim Sistemi
2nd SOUTHEAST EUROPEAN CONGRESS OF EMERGENCY AND DISASTER MEDICINE, İstanbul, Türkiye, 20 Haziran 2019, ss.49, (Özet Bildiri)
Introduction
Marijuana use is increasing worldwide. It is reported to cause ischemic strokes, hepatitis, anxiety, and
psychosis, coronary vasospasm and acute myocardial infarction. Pulmonary complications as aspiration
pneumonitis, and septic embolism were reported, but pulmonary embolism due to thrombosis is so rare.
Herein, we describe the case of AMI caused by a thrombosis of the right coronary artery and pulmonary
embolism associated with marijuana abuse.
Case
A 56-year-old man with no relevant risk factors for coronary artery disease was admitted to our hospital
because of presyncope and retrosternal chest pain radiating to both arms after inhaling marijuana
approximately 4 hours ago. His blood pressure was 75/57 mm Hg. An electrocardiogram showed sinus
rhythm of 65 bpm, and 0.5 mm ST-segment elevation formations on lead II, III and aVF derivations with
Q waves. The patient was given aspirin, followed by clopidogrel and intravenous heparin. Thereafter,
the patient was taken immediately to the coronary angiography for PCI. It was observed that patient had
total occlusion of proximal portion of the RCA. And also in CT angiography of thorax, there was
subsegmental pulmonary embolism bilaterally. During follow-up in coronary unit, cardiac tamponade
was evolved. After pericardial drainage, he became stabil. The patient was discharged without any other
complications after 8 days.
Discussion
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. Also in our
case, there was pulmonary embolism. In vitro studies have shown that cannabis may have procoagulant
effects, through increased expression of glycoprotein IIb-IIIa and P-selectin on platelets. Also it induces
platelet aggregation. So marijuana may give rise to many thrombogenic events.
Keywords:marijuana;pulmonary embolism;acute myocardial infarction