title: Cannabis-associated myocardial infarction in a young man with normal coronary arteries.
abstract: BACKGROUND
  The use of cannabis is not usually regarded as a risk factor for acute coronary syndrome. However, several cases of myocardial infarction (MI) associated with cannabis use have been reported in the scientific literature. The etiology of this phenomenon is not known.
  
  
  OBJECTIVE
  To present a case of cannabis-associated MI in which atherosclerotic coronary disease was excluded as a potential etiology by intravascular ultrasound examination, and briefly review the other possible mechanisms by which this effect may be mediated.
  
  
  METHODS
  We present the case of a previously healthy 21-year-old man who regularly smoked cannabis and presented to the Emergency Department with ST-elevation myocardial infarction after participating in a sport. He was also a cigarette smoker, but had no other conventional cardiovascular risk factors. At coronary angiography, a large amount of thrombus was found in the left anterior descending coronary artery. He recovered with medical treatment, and subsequent intravascular ultrasound examination showed no evidence of atherosclerosis at the site of the thrombus.
  
  
  CONCLUSIONS
  Cannabis-associated MI is increasingly recognized. The etiology is unclear, but we believe this is the first report of the phenomenon where atherosclerotic plaque rupture has been excluded as the cause with a high degree of confidence.
authors.affiliation: Department of Acute Medicine, Royal Glamorgan Hospital, Llantrisant, United Kingdom.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Hodcroft
authors.affiliation: Department of Emergency Medicine, University Hospital of Wales, Cardiff, United Kingdom.
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Rossiter
authors.affiliation: East Carolina Heart Institute, East Carolina University, Greenville, North Carolina.
authors.forename: Ashesh N
authors.initials: AN
authors.lastname: Buch
mesh_terms: D002188:Cannabis / Q000009:adverse effects*; D003328:Coronary Thrombosis / Q000209:etiology*; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects*; D009203:Myocardial Infarction / Q000209:etiology*; D055815:Young Adult
keywords: cannabis; coronary thrombosis; myocardial infarction