Cardiac sudden death in a young cannabis user

Shogo Kasuda; Takeshi Kondo; Ikuko Terazawa; Mami Morimoto; Katsuya Yuui; Risa Kudo

doi:10.1016/j.legalmed.2021.101955

Cardiac sudden death in a young cannabis user

Leg Med (Tokyo). 2021 Nov:53:101955. doi: 10.1016/j.legalmed.2021.101955. Epub 2021 Aug 19.

Authors

Shogo Kasuda¹, Takeshi Kondo², Ikuko Terazawa³, Mami Morimoto³, Katsuya Yuui³, Risa Kudo³

Affiliations

¹ Department of Legal Medicine, Nara Medical University, Kashihara, Nara, Japan. Electronic address: skasuda@naramed-u.ac.jp.
² Division of Legal Medicine, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
³ Department of Legal Medicine, Nara Medical University, Kashihara, Nara, Japan.

PMID: 34438239
DOI: 10.1016/j.legalmed.2021.101955

Abstract

We report a case of sudden death due to acute coronary syndrome (ACS) in a young cannabis user. A man in his late thirties died at home, and marijuana was found. The autopsy revealed severe occlusion by an atherosclerotic plaque in the left anterior descending artery. The histopathological examination revealed ischemic changes, likely caused by cannabis-induced sympathetic β-adrenergic stimulation. Both cannabinoid receptors (CB1 and CB2) were expressed in the atherosclerotic lesions. The CB2 expression was higher than CB1 expression in the atherosclerotic plaque, corresponding to macrophage infiltration. Since cannabis is regarded as a casual drug due to its lower levels of dependency, some individuals have supported legalized marijuana use. However, this case report will provide cautions on the casual use of cannabis.

Keywords: Acute coronary syndrome; Cannabinoid receptors; Cannabis; Sudden death.

Publication types

Case Reports

MeSH terms

Cannabis* / adverse effects
Coronary Vessels
Death, Sudden, Cardiac / etiology
Hallucinogens*
Humans
Marijuana Smoking*

Substances

Hallucinogens