Recreational cannabis use causing non-ischaemic cardiomyopathy and cardioembolism in a young adult

BMJ Case Rep. 2021 Jun 1;14(6):e243193. doi: 10.1136/bcr-2021-243193.

Abstract

Cannabis is one of the most common illicit drugs and has been implicated with various complications which include stroke, acute myocardial infarction, arrhythmia and limb arteritis. We are reporting a case of a young man, who is a recreational cannabis smoker along with tobacco, who developed exertional progressive breathlessness for the last 4 months, mild cough for 2 months and acute left-sided hemiparesis along with ipsilateral facial palsy for 1 day that was attributed to an acute right middle cerebral artery territory infarct. There was also gangrene in his left forearm as a result of left radial artery thrombosis. Non-ischaemic-dilated cardiomyopathy was found in contrast-enhanced cardiac MRI and he was managed in the line of decompensated heart failure; the right-hand gangrene was later amputated in the subsequent follow-ups. Hence, cannabis can lead to cardiomyopathy and resulting cardioembolism. The mainstay of management remains supportive and avoidance of the offending agent. Social education is the need of the hour.

Keywords: cardiovascular medicine; drugs and medicines; global Health; heart failure; venous thromboembolism.

Publication types

  • Case Reports

MeSH terms

  • Cannabis* / adverse effects
  • Heart
  • Humans
  • Infarction, Middle Cerebral Artery / diagnostic imaging
  • Infarction, Middle Cerebral Artery / etiology
  • Male
  • Myocardial Infarction*
  • Stroke* / etiology
  • Young Adult