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Cannabis, collaterals, and coronary occlusion

Kalpa De Silva1, Divaka Perera1

  • 1Cardiovascular Division, Rayne Institute, St Thomas' Hospital, London SE1 7EH, UK.

Case Reports in Cardiology
|July 3, 2014
PubMed

Insights

Cannabis use may protect against severe heart attack consequences. This case study suggests collateral circulation and potential cannabinoid preconditioning mitigate ischemia severity in acute left main coronary artery occlusion.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Cannabis contains endogenous cannabinoids which may induce myocardial preconditioning.
  • Cannabinoid-induced preconditioning might offer cardioprotection during ischemic events.

Observation:

  • A 51-year-old male with regular cannabis use presented with chest pain and diaphoresis.
  • ECG revealed ST depression and ST elevation in lead aVR, indicating myocardial ischemia.
  • Coronary angiography showed acute thrombotic occlusion of the left main coronary artery (LMCA).

Findings:

  • The patient was hemodynamically stable despite LMCA occlusion.
  • Successful revascularization of the LMCA was achieved with a bare-metal stent.
  • The dominant right coronary artery (RCA) provided significant collateral circulation to the left anterior descending artery (LAD).

Implications:

  • Coronary collateralization and potential cannabinoid preconditioning may ameliorate the severity of ischemia and its consequences.
  • This case highlights a potential protective effect of cannabis use in acute coronary syndromes.
  • Further research is warranted to explore the role of cannabinoids in myocardial protection.

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