Ul Haq E, Shafiq A, Khan A A, Awan A A, Ezad S, Minteer W J, Omar B
University of South Alabama, Mobile, AL, USA.
Saint Luke's Mid America Heart Institute, Kansas City, MO, USA.
Case Rep Cardiol. 2017;2017:9252463. doi: 10.1155/2017/9252463. Epub 2017 Jul 26.
Marijuana is the most widely abused "recreational" substance in the United States, with highest prevalence in young adults. It is reported to cause ischemic strokes, hepatitis, anxiety, and psychosis. Although it is associated with dose dependent tachycardia and can lead to coronary vasospasm, it has not been directly related to acute myocardial infarction (AMI). Marijuana induced coronary vasospasm can result in endothelial denudation at the site of a vulnerable atherosclerotic plaque in response to hemodynamic stressors, potentially causing an AMI. Spice refers to herbal mixture with composition and effects similar to that of marijuana and therefore is referred to as "synthetic marijuana." Herein, we report 3 cases of spice induced ST-segment elevation myocardial infarction. All patients were relatively young and had few or absolutely no risk factors for cardiovascular disease. All patients underwent emergent coronary angiography, with two needing stent placement and the third requiring only aspiration thrombectomy. Our case series emphasizes the importance of suspecting and investigating synthetic marijuana use in low risk young adults presenting with AMI.
大麻是美国滥用最为广泛的“消遣性”物质，在年轻人中患病率最高。据报道，它会引发缺血性中风、肝炎、焦虑和精神病。尽管它与剂量依赖性心动过速有关，并可导致冠状动脉痉挛，但尚未直接与急性心肌梗死（AMI）相关联。大麻诱发的冠状动脉痉挛可导致易损动脉粥样硬化斑块部位的内皮剥脱，以应对血流动力学应激源，有可能引发急性心肌梗死。“香料”指成分和效果与大麻相似的草药混合物，因此被称为“合成大麻”。在此，我们报告3例香料诱发的ST段抬高型心肌梗死病例。所有患者相对年轻，几乎没有或完全没有心血管疾病风险因素。所有患者均接受了急诊冠状动脉造影，其中2例需要植入支架，第3例仅需进行血栓抽吸术。我们的病例系列强调了对于出现急性心肌梗死的低风险年轻成年人，怀疑并调查其使用合成大麻情况的重要性。
