Department of Cardiology, Bern University Hospital Inselspital, University of Bern, 3010, Bern, Switzerland.
BMC Cardiovasc Disord. 2021 Mar 23;21(1):147. doi: 10.1186/s12872-021-01953-3.
The recreational drugs cannabis and nitrous oxide (NO) are known for pro-atherogenic effects and are associated with an elevated risk of myocardial infarction. These cardiovascular effects might be underestimated by the public. Culprit-lesion composition of myocardial infarctions associated with cannabis and NO has been unknown so far. This case report aims to raise the awareness of the adverse cardiovascular effects of cannabis and NO and reports, for the first time, optical coherence tomography (OCT) findings of the culprit lesion.
This is a case report of a 27-year old man with anterior ST-segment-elevation myocardial infarction (STEMI) after intoxication with cannabis and NO. Coronary angiography and OCT revealed plaque erosion with subsequent subtotal thrombotic occlusion of the left anterior descending artery that was successfully treated with 1 drug-eluting stent. The patient was symptom free at 6 months follow-up and had been able to abstain from drug consumption.
This is the first case to demonstrate the association between cannabis and NO abuse and plaque erosion on OCT in a young man with STEMI. In contrast to smoking, whose adverse effects are well-known, the cardiovascular effects of cannabis and NO might be underestimated. These adverse effects should gain more awareness in the public to prevent early vascular events in young adults.
消遣用大麻和一氧化二氮（N2O，俗称笑气）已知具有动脉粥样硬化作用，并与心肌梗死风险增加相关。这些心血管效应可能被公众低估了。迄今为止，与大麻和 N2O 相关的心肌梗死的罪犯病变成分尚不清楚。本病例报告旨在提高公众对大麻和 N2O 的不良心血管效应的认识，并首次报告罪犯病变的光学相干断层扫描（OCT）结果。
这是一例 27 岁男性，因吸食大麻和 N2O 后发生前壁 ST 段抬高型心肌梗死（STEMI）。冠状动脉造影和 OCT 显示斑块侵蚀，随后左前降支发生次全血栓闭塞，成功植入 1 枚药物洗脱支架。患者在 6 个月随访时无症状，且已能够戒除药物。
这是首例在年轻 STEMI 患者中，通过 OCT 显示大麻和 N2O 滥用与斑块侵蚀相关的病例。与众所周知的吸烟的不良影响不同，大麻和 N2O 的心血管效应可能被低估。这些不良效应应该在公众中引起更多的关注，以预防年轻人的早期血管事件。
