Young cannabis user developed rare left main coronary artery blood clot | Research

The takeaway

A young male cannabis consumer presented with a mobile thrombus in the left main coronary artery causing a non-ST-elevation myocardial infarction, successfully treated with manual aspiration and anticoagulation.

Cardiologists, emergency medicine physicians, and cannabis users interested in cardiovascular risks.

Mobile thrombus in the left main coronary artery in a young cannabis user

What the researchers found

Coronary angiography revealed a mobile thrombus in the left main coronary artery, a rare and potentially fatal finding, in a young male cannabis consumer. The patient was successfully treated with manual aspiration thrombectomy, dual antiplatelet therapy, and unfractionated heparin.

Why it matters

Left main coronary thrombus is a life-threatening finding usually associated with atherosclerotic plaque rupture. Its occurrence in a young cannabis user without typical risk factors raises questions about cannabis as a prothrombotic trigger.

The numbers in context

Young male patient; left main coronary artery thrombus; non-ST-elevation myocardial infarction; treated with manual aspiration, dual antiplatelet therapy, and heparin

How the study worked

Single case report documenting clinical presentation, coronary angiography findings, and management of left main coronary thrombus in a young cannabis user presenting with non-ST-elevation myocardial infarction.

What this study cannot tell us

Single case report. Cannot prove cannabis caused the thrombus. Other prothrombotic factors may not have been fully evaluated. No systematic comparison to other cases.

How to read the evidence

Single case report with no ability to establish causation, though the rarity and severity of the finding warrant documentation.

When this study was published

Published in 2021.

The bigger picture

This case adds to accumulating reports of acute coronary events in young cannabis users and suggests cannabis may promote coronary thrombosis through mechanisms distinct from traditional atherosclerotic risk factors.

Questions still open

What is the mechanism by which cannabis might promote coronary thrombosis? Is this risk related to frequency, method, or potency of use? How often do young cannabis users present with coronary thrombosis without being recognized?

Common questions

Is a left main coronary thrombus common?

No. It is a rare angiographic finding typically associated with very serious outcomes including sudden death and cardiogenic shock. Its occurrence in a young person without typical risk factors is particularly unusual.

Did the patient survive?

Yes. The patient was successfully treated with manual blood clot removal, blood-thinning medications, and antiplatelet therapy.

Read the original research

Left main coronary artery thrombus after cannabis consumption: a case report.

European heart journal. Case reports, 5(6), ytab179

View on PubMed ↗Publisher’s paper ↗

Citation

Matta, Anthony; Elenizi, Khaled; Elbaz, Meyer; Roncalli, Jerome. (2021). Left main coronary artery thrombus after cannabis consumption: a case report.. European heart journal. Case reports, 5(6), ytab179. https://doi.org/10.1093/ehjcr/ytab179