A 36-year-old woman with CHS developed aortic blood clot and coronary artery disease | Research

The takeaway

A 36-year-old woman with cannabinoid hyperemesis syndrome presented with chest pain and was found to have coronary artery disease and an aortic mural thrombus, requiring surgical intervention because CHS prevented antiplatelet therapy.

Cardiologists, emergency medicine physicians, and surgeons managing CHS patients with comorbidities.

CHS prevented standard antiplatelet therapy, forcing surgical intervention

What the researchers found

The patient had single-vessel coronary artery disease and an aortic mural thrombus. Standard treatment (antiplatelet therapy) was not possible because CHS caused inability to tolerate oral medication, necessitating coronary artery bypass and surgical thrombectomy instead.

Why it matters

This case illustrates how CHS can complicate treatment of other serious conditions. The persistent vomiting of CHS prevented oral antiplatelet therapy, forcing a more invasive surgical approach. It also raises questions about whether chronic cannabis use contributed to the cardiovascular pathology.

The numbers in context

Age 36. Single-vessel coronary artery disease. Aortic mural thrombus. Required CABG and surgical thrombectomy due to CHS preventing antiplatelet therapy.

How the study worked

Single case report documenting a 36-year-old woman with CHS who presented with chest pain. Clinical management described including diagnostic workup and surgical intervention.

What this study cannot tell us

Single case. Cannot establish whether cannabis caused the cardiovascular pathology. The patient may have had other unmentioned risk factors.

How to read the evidence

Single case report. Cannot establish causation but documents a clinically important complication.

When this study was published

2021 case report.

The bigger picture

Cardiovascular complications in cannabis users are increasingly reported but poorly understood. This case adds a unique angle: CHS not only represents a direct cannabis health risk but can also prevent standard medical treatment of other conditions.

Questions still open

Did chronic cannabis use contribute to this patient's cardiovascular disease? How common are serious cardiovascular events in CHS patients? Should CHS patients receive cardiovascular screening?

Common questions

Can cannabis cause heart problems?

This case cannot prove causation, but a 36-year-old with CHS developing coronary artery disease and aortic thrombus is unusual for her age and raises the question of whether chronic cannabis use contributed.

How did CHS complicate treatment?

CHS caused persistent vomiting that prevented the patient from taking oral antiplatelet medications (standard treatment for coronary disease and blood clots), forcing surgical intervention instead.

Read the original research

Aortic Mural Thrombus and Acute Coronary Syndrome in a Patient With Cannabinoid Hyperemesis Syndrome.

JACC. Case reports, 3(4), 694-696

View on PubMed ↗Publisher’s paper ↗

Citation

Labrada, Lyana; Patil, Aadhar; Lakhter, Vladimir; Minakata, Kenji; Islam, Sabrina. (2021). Aortic Mural Thrombus and Acute Coronary Syndrome in a Patient With Cannabinoid Hyperemesis Syndrome.. JACC. Case reports, 3(4), 694-696. https://doi.org/10.1016/j.jaccas.2021.02.020