Cannabis consumption and myocardial infarction: a reportof two cases

Abstract Background Cannabis is the most widely consumed illicit substance in northern Morocco. An increasing body of literature relates acute cannabis use with major cardiovascular events, particularly acute myocardial infarction (AMI), in young adults without traditional coronary artery disease risk factors. Case presentation We report two cases of young men who developed ST-elevation myocardial infarction (STEMI) following active cannabis consumption. Case 1: a 29-year-old male who presented with atypical epigastric symptoms, developed cardiorespiratory arrest shortly after electrocardiogram (ECG) acquisition and died; post-mortem examination confirmed recent myocardial necrosis, although the causal link to cannabis remains presumptive in the absence of toxicological confirmation. Case 2: a 31-year-old male with combined cannabis and cocaine use who presented with a 7-hr history of epigastric pain; coronary angiography demonstrated multi-segment coronary thrombosis of the left anterior descending artery (LAD) without spasm or dissection, successfully managed by percutaneous coronary intervention (PCI). Conclusions These cases suggest that cannabis consumption may be a trigger for AMI, even in young adults without traditional cardiovascular risk factors. Coronary thrombosis was documented in Case 2, potentially aggravated by polydrug use. Atypical presentations, such as epigastric pain, should prompt active exclusion of AMI in young cannabis users. Larger prospective studies are needed to characterise the incidence, mechanisms and optimal management of cannabis-associated AMI in a better way.