Aortic Mural Thrombus and Acute Coronary Syndrome in a Patient With Cannabinoid Hyperemesis Syndrome

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Lyana Labrada1, Aadhar Patil1, Vladimir Lakhter2

  • 1Lewis Katz School of Medicine Temple Heart and Vascular Institute, Philadelphia, Pennsylvania, USA.

JACC. Case Reports
|July 28, 2021
PubMed

Insights

Cannabinoid hyperemesis syndrome poses unique challenges in managing cardiovascular conditions. This case highlights surgical intervention for coronary artery disease and aortic thrombus when antiplatelet therapy is contraindicated.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Gastroenterology

Background:

  • Cannabinoid hyperemesis syndrome (CHS) is characterized by recurrent nausea, vomiting, and abdominal pain.
  • CHS management can be complicated by the need for antiplatelet therapy in patients with cardiovascular disease.
  • Cardiovascular complications in CHS patients are rarely reported.

Purpose of the Study:

  • To describe a unique case of managing coronary artery disease and aortic mural thrombus in a patient with CHS.
  • To illustrate an alternative surgical approach when antiplatelet therapy is not feasible due to CHS.

Main Methods:

  • Coronary artery bypass grafting (CABG) was performed for single-vessel coronary artery disease.
  • Surgical thrombectomy was conducted for an aortic mural thrombus.
  • Management decisions were guided by the patient's intolerance to antiplatelet agents due to CHS.

Main Results:

  • Successful surgical revascularization and thrombus removal were achieved.
  • The patient tolerated the surgical procedures without complications related to CHS.
  • Alternative management strategies were effective in this complex case.

Conclusions:

  • Surgical intervention can be a viable option for managing cardiovascular disease in CHS patients unable to tolerate antiplatelet therapy.
  • This case underscores the importance of individualized treatment plans for patients with co-existing conditions.
  • Further research is needed to explore optimal management strategies for cardiovascular issues in CHS patients.

Keywords:
CABG, coronary artery bypass graftLAD, left anterior descendingchest paincoronary angiographythrombosis

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