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Study breakdown

Autopsy revealed organized coronary blood clot in a 34-year-old marijuana user with no atherosclerosis

Case ReportPreliminary evidence
The takeaway

A 34-year-old man with no medical history except marijuana use died suddenly from a completely blocked coronary artery caused by an organized blood clot, with no underlying atherosclerosis found.

Forensic pathologists, cardiologists, emergency medicine physicians

Complete coronary occlusion with zero atherosclerosis

What the researchers found

Autopsy of a 34-year-old man with no previous medical history besides marijuana use revealed focal complete occlusion of the proximal left anterior descending coronary artery by an organized thrombus. No atherosclerotic plaques were found in any coronary artery. Toxicology showed elevated delta-9-THC levels (50 mg/mL). The cause of death was myocardial ischemia leading to fatal cardiac arrhythmia from coronary artery occlusion without atherosclerosis.

Why it matters

This autopsy case provides direct pathological evidence that marijuana use may cause coronary thrombosis without underlying atherosclerosis in young adults, a finding consistent with proposed mechanisms including arteritis, vasospasm, and platelet aggregation.

The numbers in context

34-year-old male; delta-9-THC 50 mg/mL; complete occlusion of proximal LAD; organized thrombus; no atherosclerosis in any coronary artery; mild cardiomegaly

How the study worked

Complete autopsy with gross and microscopic examination. Trichrome and elastin stains performed on coronary arteries. Blood and vitreous fluid toxicology analysis.

What this study cannot tell us

Single case report cannot establish causation between marijuana use and coronary thrombosis. Organized thrombus suggests a non-acute event, and the temporal relationship to cannabis use is unclear. Other potential thrombotic risk factors may not have been fully evaluated.

How to read the evidence

Single autopsy case provides direct pathological evidence of coronary thrombosis in a cannabis user, but cannot establish a causal relationship.

When this study was published

2025 publication

The bigger picture

Sudden cardiac death in young adults without traditional risk factors challenges conventional cardiovascular risk assessment. This case adds to the small but growing body of autopsy evidence linking cannabis use to coronary events through non-atherosclerotic mechanisms.

Questions still open

  • How common is non-atherosclerotic coronary thrombosis among cannabis users? Should young adults who use cannabis regularly undergo cardiovascular screening?

Common questions

How can a blood clot form without blocked arteries?
Proposed mechanisms for cannabis-related coronary thrombosis include arteritis (vessel wall inflammation), vasospasm (sudden vessel narrowing), and enhanced platelet aggregation (blood clotting). These can cause clots without the cholesterol buildup of atherosclerosis.
Does this mean marijuana causes heart attacks?
This single case cannot prove causation, but it documents a plausible pathway. The complete absence of atherosclerosis in a 34-year-old with no other risk factors besides marijuana use is notable and consistent with reports from other cases.

Read the original research

A Fatal Case of Coronary Thrombosis in a Young Male Triggered by Marijuana Use.

Cureus, 17(11), e98083

Citation

Aravind, Akhila; Kyle, Patrick B; Subramony, Charulochana. (2025). A Fatal Case of Coronary Thrombosis in a Young Male Triggered by Marijuana Use.. Cureus, 17(11), e98083. https://doi.org/10.7759/cureus.98083