Cannabis-Associated Spontaneous Coronary Artery Dissection in a Community Hospital: A Case-Based Focused Literature Review

This case report highlights a rare and diagnostically challenging presentation of spontaneous coronary artery dissection (SCAD) in a healthy 39-year-old woman, with symptoms beginning while smoking cannabis after heavy recent use. It also underscores real-world limitations in community settings where advanced intracoronary imaging may be unavailable or unsuitable and where diagnosis and management rely on angiographic morphology and clinical context. In our patient, angiography localized the culprit to the distal left circumflex (LCx) artery, with minimal atherosclerotic burden elsewhere. Extracoronary imaging was negative for fibromuscular dysplasia (FMD), and follow-up CT coronary angiography demonstrated interval healing features that strengthened diagnostic confidence compared with many prior published cannabis-related cases. The favorable outcome with conservative therapy aligns with contemporary recommendations for stable SCAD, supporting noninterventional strategies when high-risk features are absent. Overall, this report adds to the limited literature linking cannabis exposure to SCAD and highlights cannabis as a possible, under-recognized trigger warranting greater clinician awareness and further investigation.