Synthetic cannabinoids and ST elevation myocardial infarction

Am J Med Sci. 2022 Oct;364(4):481-491. doi: 10.1016/j.amjms.2022.05.001. Epub 2022 May 8.

Abstract

Synthetic cannabinoids cannot be detected on a standard urine drug screen (UDS), making them a convenient drug of abuse. We report the first case of ST elevation myocardial infarction (STEMI) in a young patient due to coronary artery thrombosis secondary to synthetic cannabinoid use and concurrent COVID-19 infection. A 38-year-old previously healthy male developed severe chest pain and was found to have anterior STEMI and COVID-19 infection. Coronary angiography showed acute thrombotic occlusion of the mid-left anterior descending artery that was managed with thrombectomy and stent placement. He only required supportive care for COVID-19. A comprehensive literature search revealed 34 additional cases of STEMI with synthetic cannabinoid use; majority were males (97%) with mean age of 29 years. 29 patients (85.3%) underwent coronary angiography and majority had left anterior descending artery (LAD) involvement (55%), with 13 (44.8%) undergoing stent placement. We highlight STEMI as a potentially lethal complication of synthetic cannabinoids; prompt angiography may be lifesaving.

Keywords: Acute coronary syndrome; COVID-19; K2; Spice; Synthetic cannabinoids.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • COVID-19*
  • Cannabinoids* / adverse effects
  • Coronary Angiography
  • Coronary Thrombosis* / complications
  • Female
  • Humans
  • Male
  • ST Elevation Myocardial Infarction* / diagnostic imaging
  • ST Elevation Myocardial Infarction* / etiology
  • ST Elevation Myocardial Infarction* / surgery

Substances

  • Cannabinoids