Synthetic Cannabinoid (Mojo)-Induced ST-Segment Elevation Myocardial Infarction: A Case Report

Synthetic cannabinoids, such as Mojo, are increasingly used among adolescents and young adults due to their perceived legality and accessibility. These compounds exhibit significantly greater potency than natural cannabis, with full agonist activity at cannabinoid receptors, and have been associated with a range of adverse effects, including cardiovascular toxicity. The underlying mechanisms may involve sympathetic stimulation, platelet aggregation, and endothelial injury, which can precipitate acute coronary events even in otherwise healthy individuals. We report the case of a 32-year-old man with no significant medical history and an atherosclerotic cardiovascular disease (ASCVD) risk score of 3.6%, who presented with acute chest pain four hours after smoking the synthetic cannabinoid Mojo. Electrocardiogram revealed ST-segment elevations, and emergent left heart catheterization demonstrated acute thrombotic total occlusion of the left circumflex artery. The patient was successfully treated with percutaneous coronary intervention (PCI) and stent placement. Urine drug screening confirmed recent synthetic cannabinoid use. He had no identifiable traditional cardiovascular risk factors or family history of heart disease. This case highlights synthetic cannabinoids as an emerging and underrecognized cause of acute coronary syndrome in young adults. Clinicians should maintain a high index of suspicion for synthetic cannabinoid use in young patients presenting with myocardial infarction without conventional risk factors. A simple urine drug screen can be a critical diagnostic tool. This report emphasizes the need for increased awareness, targeted patient education, and further research into the cardiovascular risks posed by these substances.