21-year-old had four heart attacks linked to cannabis use

A 21-year-old man with no cardiovascular risk factors experienced four acute coronary syndrome events over 18 months, each involving thrombotic coronary artery occlusion requiring intervention. Each event was preceded by cannabis consumption. Despite dual antiplatelet therapy, events recurred while he continued using cannabis. After cessation, he remained symptom-free for 8 months.

Single case report with detailed clinical documentation of four ACS events including coronary angiography, treatment records, and 8-month follow-up after cannabis cessation.

While cannabis-related heart attacks in young adults are rare, this case is striking because of the recurrence pattern: four events directly linked to continued cannabis use, with resolution after stopping.

This case adds to a small but growing literature linking cannabis to acute coronary events in young adults, likely through coronary vasospasm or prothrombotic effects. It suggests that for rare susceptible individuals, cannabis may pose serious cardiovascular risk.

Single case report cannot prove causation; no toxicology confirmation of cannabis as sole substance; temporal association does not exclude other triggers; extremely rare presentation.