Marijuana-induced myocarditis in a 24-year-old man

Toktam Alirezaei, Mohammad Kalateh Agha Mohammadi, Rana Irilouzadian, Hamidreza Zarinparsa

Abstract


As marijuana, the most widely-used illicit drug in adolescents and adults, has some unknown side effects, marijuana abuse has become a public health concern. Also, marijuana affects different organs such as heart in its rate, rhythm and coronary flow; it eventually leads to events such as myocardial infarction and rarely myocarditis. A 24-year-old man without any medical history or cardiovascular risk factors presented with chest pain after marijuana consumption. Based on electrocardiogram, myocardial cytolysis and transthoracic echocardiography acute myocarditis diagnosis was established. A few days later, transthoracic echocardiography showed a small clot in apex with reduced left ventricle ejection fraction, in the absence of local akinesia. The patient was discharged with oral anticoagulant stable and without any symptoms. The myocarditis after marijuana abuse is rare. The physicians should include acute myocarditis in differential diagnosis of a patient with chest pain after using marijuana.

Keywords


marijuana abuse; myocarditis; cannabis

Full Text:

PDF

References


World drug report 2021. Vienna: UN, Office on Drugs and Crime; 2021 [https://www.unodc.org/unodc/en/data-and-analysis/wdr2021.html available at 06/20/2022]

Suerken CK, Reboussin BA, Sutfin EL, Wagoner KG, Spangler J, Wolfson M. Prevalence of marijuana use at college entry and risk factors for initiation during freshman year. Addict Behav. 2014; 39(1):302-307. doi: 10.1016/j.addbeh.2013.10.018

Volkow ND, Baler RD, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med. 2014; 370(23):2219-2227. doi: 10.1056/NEJMra1402309

Amar MB. Cannabinoids in medicine: A review of their therapeutic potential. J Ethnopharmacol. 2006; 105(1-2):1-25. doi: 10.1016/j.jep.2006.02.001

McLaren J, Swift W, Dillon P, Allsop S. Cannabis potency and contamination: a review of the literature. Addiction. 2008; 103(7):1100-1109. doi: 10.1111/j.1360-0443.2008.02230.x

Mach F, Montecucco F, Steffens S. Cannabinoid receptors in acute and chronic complications of atherosclerosis. Br J Pharmacol. 2008; 153(2):290-298.

Kattoor A, Mehta J: Marijuana and coronary heart disease. American College of Cardiology [https://www.acc.org/latest-in-cardiology/articles/2016/09/22/08/58/marijuana-and-coronary-heart-disease available at 06/20/2022]

Feldman AM, McNamara D. Myocarditis. N Engl J Med. 2000; 343(19):1388-1398. doi: 10.1056/NEJM200011093431908

Fabre A, Sheppard MN. Sudden adult death syndrome and other non-ischaemic causes of sudden cardiac death. Heart. 2006; 92(3):316-320. doi: 10.1136/hrt.2004.045518

Kariyanna PT, Jayarangaiah A, Singh N, et al. Marijuana induced myocarditis: a new entity of toxic myocarditis. Am J Med Case Rep. 2018; 6(9):169-172. doi: 10.12691/ajmcr-6-9-1

Leontiadis E, Morshuis M, Arusoglu L, Cobaugh D, Koerfer R, El-Banayosy A. Thoratec left ventricular assist device removal after toxic myocarditis. Ann Thorac Surg. 2008; 86(6):1982-1985. doi: 10.1016/j.athoracsur.2008.04.092

Rodríguez-Castro CE, Alkhateeb H, Elfar A, Saifuddin F, Abbas A, Siddiqui T. Recurrent myopericarditis as a complication of marijuana use. Am J Case Rep. 2014; 15:60-62. doi: 10.12659/AJCR.889808

Tournebize J, Gibaja V, Puskarczyk E, Popovic B, Kahn J-P. Myocarditis and cannabis: An unusual association. Toxicol Anal Clin. 2016; 28(3):236. doi: 10.1016/j.toxac.2016.05.005

Nappe TM, Hoyte CO. Pediatric death due to myocarditis after exposure to cannabis. Clin Pract Cases Emerg Med. 2017; 1(3):166-170. doi: 10.5811/cpcem.2017.1.33240

Yamamoto I, Watanabe K, Matsunaga T, Kimura T, Funahashi T, Yoshimura H. Pharmacology and toxicology of major constituents of marijuana—on the metabolic activation of cannabinoids and its mechanism. Toxin Rev. 2003; 22(4):577-589. doi: 10.1081/TXR-120026915

Franz CA, Frishman WH. Marijuana use and cardiovascular disease. Cardiol Rev. 2016; 24(4):158-162. doi: 10.1097/CRD.0000000000000103

Tso M, Kushneriuk DJ, Bree TL, Nosib SS. Incidental acute ST elevation due to cannabis-induced myocarditis after a mechanical fall. CJC Open. 2021; 3(10):1303-1306. doi: 10.1016/j.cjco.2021.05.008

Magnani JW, Dec GW. Myocarditis: current trends in diagnosis and treatment. Circulation. 2006; 113(6):876-890. doi: 10.1161/CIRCULATIONAHA.105.584532

Smith SC, Ladenson JH, Mason JW, Jaffe AS. Elevations of cardiac troponin I associated with myocarditis: experimental and clinical correlates. Circulation. 1997; 95(1):163-168. PMID: 8994432.

Nishii M, Inomata T, Takehana H, et al. Serum levels of interleukin-10 on admission as a prognostic predictor of human fulminant myocarditis. J Am Coll Cardiol. 2004; 44(6):1292-1297. doi: 10.1016/j.jacc.2004.01.055




DOI: http://dx.doi.org/10.22551/2022.35.0902.10206

Copyright (c) 2022 Toktam Alirezaei, Mohammad Kalateh Agha Mohammadi, Rana Irilouzadian, Hamidreza Zarinparsa

Creative Commons License
Archive of Clinical Cases is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

 

ISSN: 2360-6975