Heart attack in a 21-year-old cannabis user with completely normal arteries
A 21-year-old regular cannabis user had a heart attack with a large blood clot in a coronary artery, but intravascular ultrasound confirmed his arteries were completely free of atherosclerosis.
Quick Facts
What This Study Found
A previously healthy 21-year-old man who regularly smoked cannabis presented with an ST-elevation myocardial infarction (the most serious type of heart attack) during sports activity. Coronary angiography revealed a large thrombus (blood clot) in the left anterior descending coronary artery.
The unique contribution of this case was the use of intravascular ultrasound to definitively exclude atherosclerotic plaque rupture as the cause. The arteries were completely normal, ruling out the most common mechanism of heart attack in older patients. The only cardiovascular risk factors were cannabis and cigarette smoking.
This was described as the first report where atherosclerotic plaque rupture was excluded with high confidence using intravascular imaging in a cannabis-associated heart attack.
Key Numbers
One patient, age 21. ST-elevation MI during sports. Large thrombus in left anterior descending artery. Intravascular ultrasound: no atherosclerosis at thrombus site.
How They Did This
Single case report with coronary angiography and intravascular ultrasound imaging to characterize the coronary pathology and definitively exclude atherosclerosis.
Why This Research Matters
By ruling out atherosclerosis, this case pointed to alternative mechanisms by which cannabis might trigger heart attacks, such as vasospasm, direct prothrombotic effects, or endothelial dysfunction. Understanding the mechanism is critical for assessing who is at risk.
The Bigger Picture
Cannabis-associated heart attacks in young people with normal arteries challenge the traditional model where heart attacks require pre-existing coronary artery disease. If cannabis can trigger thrombosis in healthy arteries, the at-risk population may be broader than previously thought.
What This Study Doesn't Tell Us
Single case report. The patient also smoked cigarettes, which is an independent cardiovascular risk factor. Cannot definitively prove cannabis caused the event. Case reports cannot establish incidence rates.
Questions This Raises
- ?What is the mechanism by which cannabis triggers thrombosis in healthy arteries?
- ?Does the combination of cannabis and vigorous exercise increase risk?
- ?How common is this event among young cannabis users?
Trust & Context
- Key Stat:
- Heart attack in a 21-year-old with zero atherosclerosis confirmed by ultrasound
- Evidence Grade:
- Single case report with advanced imaging. Novel finding but limited to one patient.
- Study Age:
- Published in 2014.
- Original Title:
- Cannabis-associated myocardial infarction in a young man with normal coronary arteries.
- Published In:
- The Journal of emergency medicine, 47(3), 277-81 (2014)
- Database ID:
- RTHC-00804
Evidence Hierarchy
Describes what happened to one person or a small group.
What do these levels mean? →Frequently Asked Questions
Can you have a heart attack from cannabis if your arteries are healthy?
This case suggests yes. A 21-year-old with no atherosclerosis (confirmed by intravascular ultrasound) had a heart attack with a blood clot in a coronary artery. The mechanism may involve vasospasm or direct clotting effects rather than plaque rupture.
How rare is a cannabis-related heart attack?
Case reports like this are uncommon, and the actual incidence is unknown. Most cannabis users will never experience this, but the fact that it can occur in young people with no other risk factors is noteworthy.
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Cite This Study
https://rethinkthc.com/research/RTHC-00804APA
Hodcroft, Christopher J; Rossiter, Melissa C; Buch, Ashesh N. (2014). Cannabis-associated myocardial infarction in a young man with normal coronary arteries.. The Journal of emergency medicine, 47(3), 277-81. https://doi.org/10.1016/j.jemermed.2013.11.077
MLA
Hodcroft, Christopher J, et al. "Cannabis-associated myocardial infarction in a young man with normal coronary arteries.." The Journal of emergency medicine, 2014. https://doi.org/10.1016/j.jemermed.2013.11.077
RethinkTHC
RethinkTHC Research Database. "Cannabis-associated myocardial infarction in a young man wit..." RTHC-00804. Retrieved from https://rethinkthc.com/research/hodcroft-2014-cannabisassociated-myocardial-infarction-in
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.