Coronary vasospasm complicating cannabinoid hyperemesis syndrome
Sophie Pierard1, Philippe Hantson2,3
1Department of Cardiovascular Intensive Care, Université Catholique de Louvain, Brussels, Belgium.
Journal of Cardiology Cases
|October 4, 2018
Summary
Cannabinoid hyperemesis syndrome (CHS) involves nausea, vomiting, and pain in long-term cannabis users. This case highlights potential cardiac events, like myocardial infarction, linked to cannabis use, even with atypical symptoms.
Area of Science:
- Gastroenterology
- Cardiology
- Toxicology
Background:
- Cannabinoid hyperemesis syndrome (CHS) is a condition in long-term cannabis users, marked by cyclic nausea, vomiting, and abdominal pain.
- Its pathophysiology is linked to Cannabinoid-1 (CB-1) receptor dysregulation.
- Cannabis use is increasingly associated with triggering acute coronary syndrome (ACS) in young men.
Observation:
- A 41-year-old man with a history of cannabis smoking presented with epigastric and retrosternal pain.
- Investigations for gastrointestinal causes were negative.
- An episode revealed takotsubo cardiomyopathy, followed by ST-elevation myocardial infarction due to coronary vasospasm.
Findings:
- The case suggests a potential link between cannabis use, CHS symptoms, and serious cardiac events such as coronary vasospasm.
- Atypical pain in CHS patients may indicate underlying cardiac issues.
Implications:
- CHS patients with unusual pain patterns require thorough cardiac evaluation.
- Further research is needed to establish the causal link between CHS and ACS.
- This case underscores the importance of considering cardiovascular risks in chronic cannabis consumers.
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