Zafrullah Fnu, Raheela Fnu, Ali Farman, Zafar Shumaila, Ayoob Nusrat, Majid Abdul, Talpur Abdul Subhan
Interventional Cardiology, Ascension Borgess hHospital, Kalamazoo, USA.
Internal Medicine, Chandka Medical College, Larkana, PAK.
Cureus. 2024 Apr 29;16(4):e59284. doi: 10.7759/cureus.59284. eCollection 2024 Apr.
This case report presents a detailed examination of spontaneous coronary artery dissection (SCAD) in a 61-year-old Middle Eastern male with a history of marijuana use and essential hypertension. The patient's emergency presentation with loss of consciousness and subsequent diagnostics - including elevated troponins and distinctive electrocardiogram changes - led to the identification of extensive SCAD affecting multiple coronary arteries. The association between marijuana use and cardiovascular pathology is focal in this study, particularly considering the patient's positive test for tetrahydrocannabinol (THC) and significant smoking history. This case highlights the critical need for heightened awareness among clinicians regarding the implications of recreational marijuana use, particularly in individuals with predisposing cardiovascular risk factors. Furthermore, it illustrates the complexity of diagnosing and managing SCAD, a condition that may vary widely in its presentation and severity, necessitating a tailored approach to treatment that considers both the acute manifestations and underlying contributory factors such as substance use.
本病例报告详细检查了一名61岁中东男性的自发性冠状动脉夹层(SCAD),该患者有吸食大麻和原发性高血压病史。患者因意识丧失紧急就诊,随后的诊断——包括肌钙蛋白升高和独特的心电图变化——导致发现广泛的SCAD累及多条冠状动脉。在本研究中,吸食大麻与心血管病理之间的关联是重点,特别是考虑到患者四氢大麻酚(THC)检测呈阳性以及有大量吸烟史。该病例突出表明,临床医生迫切需要提高对吸食消遣性大麻影响的认识,尤其是在有易患心血管危险因素的个体中。此外,它说明了诊断和管理SCAD的复杂性,这种疾病的表现和严重程度可能有很大差异,需要一种量身定制的治疗方法,既要考虑急性表现,也要考虑诸如药物使用等潜在的促成因素。